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Meter Swap Y • � Request Number: 14564 Pablic works Division Service Request Problem Address: 5217 Matterhorn Dr Requested By: Ya Zang Department: WA'IER Address: No acld�-ess�xovided Prohlem/Issue: INSTAI.L AMR ME1ER Phone Number: 6S 1-366-84U2 Scheduled 2017-04-07 Scheduled 11me: 10:00:0(� � � ACIION NEEDED: Created by: Beth Kondrick Date Cre�ed: 2Q 1?-04-06 ACTION TAI�N: �v�� '�� Statns: jn Progess Submitter Has Been �.., Co�rtacted Date Campleted: Completed by: �' - � � �vl � `� � r �fS- ��,3�-��t, d� r �j-� � �`71 City of Fridley Water Department 6431 University Avenue NE Fridiey,MN 55432 763-572-3566 Ijwe hereby authorize the City of Fridiey andjo�its employees to do what is necessary to replace the water metec. 1 understand that the property owner is fiabie for the water line from the main to the premise and all iMerior p{umbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmiess for arry damages that may occu�while doing this operation. This to include,but not IimRed to valves,piping,walis,floors or the a,�rb stop box and senrice line. In understand 1 am aiso requi�ed to obtain a permit prior to any work,if necessary. FINAL METER READING(oid meter) � � � J �� Name: Y�a I�YI, Address__�� !� � '��. {s.�— Phone Number `C�J� �`�J ��ate +r � "� ` y Signature Witness Signature OLD METER# � " ��.J � 1 �� OLD READING 2-t �� v NEW METER# �� vV� � V i NEW READING � ERT# � �� FRIDLEY CfTY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,5b6,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT PEE Prior to rnnstructing ar repair of any water of sewer line connecting tfie existing municipal system and any house or buildirtg for which the applicatfon is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connedio�has been made,the Water and Sewer DepartmeM shaN be notified. it shall be unlaMrful to cover any wnnecting line untll an inspection has been made and wch connection and the work incident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAfRS AND MAINTENANCE TO CONNECTION After the initial connection has bee�made to the water service cu�b stop box or the sewer lead at the property line or a water service lead has been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shall be liable for all repairs required to arry water li�e and sewer lines necessary for connecNon of the premises from the main to the premises. If the property owner requests maintenance service or repairs be pesformed by the City,the property owner sfiall be charged for the casts of the maintenance and/or repairs,includi�g necessary street repairs at a rate set annuafly by an admis�istrative po{iry. ft shaN be the responsibility of the applicar�t, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or �oot cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the flnished grade ofi the land or property. (Ref 638,1156,1191) R�quest tor Service Report City af Fri�il�y RefetcnceNo: �p�- �c3--��d Date: ��-'�-''C� Requext Type- ��C.��L� Entered By. Oeparkment: � � - '""' � � Litizen Nama C��`' �"��>�'��-� Addrass= �,�I� �`�(��R.� Cefiback Phone: `�� g�,� �`a�„ � Schsduled Date: Property Own�r: Location Qekails: Requext (9staila: � �E�� 1�� Action Taken; � �� — C�� -L� ��-�-�2. ��P C�C —��t� A>- 1 �� -� �� -�z��P ��,u�� , .,�� C��r� �.�� 1��c� ��C�, � 1 `Z'��Z L�,iJ� �`Z'�LL.,��5 �,°�c�� , s�� -�� l c�►� �� ; c� , � s � :��t� ��\ �-�A�� t�S`� C,�L�t� �1�C� , ��t Rr;sponsiblc Person� Approver. _._.._ _ .._ ._ _._._ _ _._- --- .._ --- -------- __.._ _. ___ ___ __.. �Citizen Notified C��mpletion D atw: i � � ^ �� __.._ _----_. R�q�t f�r� - R�p�r� �i�.y c�f F�cil+�y t� �: �-1�- �e: 7�12 � Tj�e� Sewe�hadie iip ct�c G�r�ain �y:: . 5e4rec C�zerr�: �a�ry� Add�� 5�17 MA �R HE . ��2-�88-$1� t�at+e= ��T1�72 8_3D/ril t)wr�er: ��a�: Requea�t �et�= �f�t�r liair� T _ �P�a��. Se�x b�c�p c�[. l�s a��s+of se�aer ba€�p��. .�e�ed{a�3r�ine. P�►�#�es. �T�aeir�w�t . �e r�1 #+Q � . 2i1�3 rwraa�t � � � I � E � � ___ ___. _w._...__.. � __ . __._. .______....n�. _..... _ ... _.. _ __w__._.__�..._ ------_-_____ �_.__._. _� __. ��r m� _ � ;�� J�� __ ___ �__ .. .. � � ___ _ ._..__ _._ ..__. _ C�aap�ain�be: ��i'3w�'�U12 6:17�+1 � {36aerE l�a�ied � w _ �d. . �_� . ___ _�