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Meter Swap w Request Number: 13081 Public Works Division Service Request � Problem Address: 1481 N Innsbruck Dr Requested Bys Ver�n&Donna Brewcrs Department: WATER Address: No address provided Problem/Issae: INSTAL,L AMR METER Phone Number: 574-0066 Sc�ednled D�t : 2017-02-01 Sehednled'I1me: 11:30:00 � � �r �� ACIION NEEDED• � �` • Created by; Wendy Hiatt Date Created: 2017-01-25 ACIION TAKEN: �� _._�..�► � ___ ..�_�...._. _. Statua: In progress Snbmitter Hns Beea �,.. Co�sicted Date Completed: Completed by: Z- I -- � +1 � �� Wate�l�e�artrnent 6431 University Avereue PIE � � � _� (I� _1 �� --� � � Fridley, MN 55432 r� � ' 763-5?2-3565 � �P �� 'Ne hereby authorize the City�f Fridley andjor its employees to do what is necessary to replace the water meter. 1 understand that the property awner is iiable for the water line from the main to the premise and all interior plurrabing. (Per City code 402A6) 1 also hold the C'vty of Fridley and/its empioyees harmless#or any slamages that may occur while doing this operation. This to incfude,but not limited to vaives,piping,wat(s,floors or the curb stoP box and senrice line. In understand!am aiso require� to obtain a permit prior to any�ror4c,if necessary. F11VAL METER READIN6(old meterj �� Name: ��vw � Address� ' � f�N�fiJS�V�Jl�- �rL'_ Pho�e Number ��(,i�L/I�J� p� " �"—' 1� Si nature '� y �� t g Witness Signature �"' OLD METER#_�� OLD READtNG� �) 1r-t ��.✓ NEW METER# ��+b�,l�� NEW READING ERT# �I`� � �� FRIDLEY CiTY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEINER ADMINISTRATION �Ref Ord No 113,464,565,566,629,538,662,922,988,1144,1156,1191} 402.5 PERMiT FEE Prior to constructi�ar repair�rE any water of sewer fine connecting the e�cisting muniapai system and arry house or buildir�for which the appiication is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shaii pay a permi!fee as provided irr _ Chapter 11 of this Code. After such conneccion has been made,the Water and Seaier Department sha0 be notified. it shaff be uniaxrful to cover any connecting line untii an irtspection has 6een made and such connection and the wor�c inadent thereto has been approved by the C'ity as a proper and suitable connettion. 402.06 REPAiRS AND MAINTENANCE TO CONNECTION After the inifiial connection has been made to the water service curb stop box or the sewer lead at the property line or a wa�r service lead has been extended#o the property line for connedion,the app{icarrt,owner,or accuparrt or user of such premises shall be 1�aWe for ail repairs required to any water line and sewer lines necessary for con�ection of the premises from the main to the premises. tf the property orrner requests mairitenance service or repairs be performed by the City,the property owner shall be charged for the cos�e�f the mai�rtenar�e and/or repairs,inciuding necessary street repairs at a rate set annually by an adminis#ra#ive policy. it sha0 be the responsibility of the applicant, owner,occuparrt or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains ahove the finished grade af#he land or property. (Ref 638,1156,1191) fi � � � V �,�*� � � n� �� ,J;, r=*�:, -r ' �` 'i a , �.e ,,,` .. y..,,, ��. - ��+�w...��Yy�� . Date_ � :,,�'f� '�" Old Meter Number_ 3 � }�� Old Meter Reading �'j�, � Replacement No. � j'�� .� Replacement Reading p Replacement Make��--. Remarks:_ s �i�� ,�.r—, . Signed ��