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Meter Swap � ' Request Number: 16429 Public works niv;sion Service Request Problem Address: 5432 Madison St Requested By: ` Department: WA1ER Address: No address provided Probletn/Issue: INSTALL AMR METER Phone Number: �'i Sl�..ca.�c>�C�'� Scheduled Date: 2017-07-24 Schedule@ 13me: 0230:00 � � ��3 ACTION NEEDED: Created by: Wendy Hiatt Date Created: 2017-07-24 ACTION TAi�N: _.............................._.�........_.._..__...............................................���............................._�............._.._............................___._....___.....................__._l _.........._..................._......_. ... _.._ ......._.._._._.........................................._-___._......_.._...._�........��..........._...._.�....�....—._._�..�.._..........�...s........._�`�:__.....�:.........._'.�..�......_ -__........� _... __._. .�: ............................................................................�_.._____._......................................_...__...............................................__..__........___..__._..._........__-.._.._.___-___._..._.._..._.._..�._...._ ._.....__..__. �; . Status: In Progress 5ubauitter Has Been r. Contacted � � � � Date Completed: Completed by: � 4�'���� .. .. r�....,. 't�r,. � . � . � . � . . . �. � ���� ��/��� '`�� City of Fridley �� ��07 ` Water Departra7ent " 5431 ilniv�rsity Avenue NE Fridley,MN 55432 763-572-3566 ��`"�e hereby authorize the City of Fridley and/or its employees to do what is necessary to replace#he water meter. t understand that the property owner is tiabie for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold Che City of Fridley andrts employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,pipin�walls,{Ioors or the curb stop box and service line. in understand 1 am also required to obtain a permit prior to any worh,if necessary. � , _� : FINAL METER REAQING{a1d meter} �v � ��tJ � '��:�`��Vame: Address ����1 ' ��J�N Phone N ber Date —� . Signature Witness Signature � �' l�lS ��� �� OLD 111�ETER# OLD READING /(.J'"l �: 1 U� NEW METER# �� `) ��� NEW READING_ � -+�' ERT# _�l�!Y"l � ` � ()�,_ FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AMD SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566, 629,638,662,922,988,1144, 1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connec�fitag the existing municipal system and arry house or buitding for which the application is made,the owner or contractor shail be required to obtain a permit for such connection,and shall pay a permit fee as provided i� Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an inspectioa has been made and such cannection arM the work incident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAtRS ANQ MAtNTENANCE TO COAINECTION After the initiat connection has been made to the water service curb stop Isox or the sewer lead at the property line or a water service teacl has been extended to the property line for connection,the applicant,owner,ar occuparrt or user of wch premises shali be liable for alt repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property oarner requests mair►tenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or repairs,including necessary street repairs at a rate set annualty by an administrative policy. It sfiafl6e the responsibility of the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main indudtng debris clearing or root cutting and to maintain the water service curb stop box for operability aad at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) ..E t , ,, � `�.;" �. ;,;f /