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Meter Swap Request Number: 13328 Public Works Division Service Request Problem Address: 5741 Polk St Requested By: Robert Wayne Department: WA1ER Addreas: No ad�ess ptovided Problem/Issue: INSTALL AMR ME1ER Phone Numbcr. 5�1-416? 5cbeduled Date: 201 T-0 - 4 Sc�cdnled 11me: O1:fl0:Of! �-- ��y�► .P ACTION NEEDED: Crexted by: Wendy Hiatt Date Cre�ed: 2017-02-07 ACTION TAI�N: � � �-9� �'� ___.__....___ �v:. Status: �n Progress 5abmitter Has Been r � Co�acted Dat�Completed: �� �� — 4� Completed by: ���� ------. ...�..�,.«e s�aoa.reo 543�.t0sadv�rsrty Awer�aae N� � r,, �` � � � ��ic!ley,MIN �5432 �'� ��t , ��3-5�2-�.��� �1 � �y �� 7�2-i� I �%` l/�1°� hereby authorize the�ity�f Fritiley andjor its empioyees to slo what ds necessary , regalace+t!►e water rneter. i c�nderstand tha#�he�oropee�ty owner as liabte for the water tine#rom the main to�he premise and all irrcerior ptumbing. {Per Crty soste 402,06� 0 adsa dtold the City�rF Fridley andJits employees harmless#or any damages that may accur white sloln�tt operation. Tteis to include,but noe Bimited to valves,piping,walls,#loors or�he curb stoP box and senrice line. 1n undersfiand�am also aeq to obtain a permifi prso�r to any aeror4c,�f�ecessary. F1f11AL NtEi'ER READIAIG�old mefier� ���� { � Name:�6�J'�'� �'G.�IiL'e. Address � / � ( �(��,�- 5�' - Phone Number �� �`" L� ��� Date �— � 1� �� S�gnatur� ��S�� �-- OLD MET�R#_�� �/Q�Q� '�G'f 01.D READ[NG_I ��� i � 11iEW METER#_�� 1 U � / � NEW READtOVG � ���# � � � i c� '� 13 � fRIDCEY CITY CODE CHAPTER 4Q2.WA'!'ER,570RM WATER/�14YD SANITARY SEIA/ER ADMlHlSTRATIO'Rt �Ref Orsi l�io iZ3,4�64,565,5�6,629,638,662,922,988,1144.,115b,1191j 4Q2.5 AERMIT FEE Prior to cor+structing ar sepair vE any water vF sewer tine connecting the ercisting muniapat sys#sm and arry twuse oir buik#ir�for which the appiicafiion is made,the owner or corrtractor shall be cequired to abtain a permtt for such connection,and shall pay a permit fee as provided Cha�ter 11 of this Code. After such connectian has been made,the�later and Searer Departmerrt sha!!be notified. it shail�unlawful to co arry conneding line urrti!an inspecti�n has been made and such connecCion and the rrork inaderrt thereto has been appcoved fsy the City as a proper and suitable connection. 402.06 REPAlRS QND MAfNTEA1p11►CE TO CONNEC17�t Aftet the in'rtial connecAvn has been made ta the water service curb stop box or the seurer lead at the property iine a�a water servke�ead{�a been extended to the pveperty fi»e for connedion,the appiicarrt,owner,ar accx+part!vr user af wch premises sbap be tiable for a!I repairs reqeaired to any water line and sewer lines necessary for connection of the premises from the main to the premises. If tS�e property owner requests mairrtenance senrice vr repairs be perFormed by tf�e City,the property owner shail be charged for the tosts af Lhe mairrCenance and/ repairs,inciuding necessary s#reet repairs at a rate set annually b�an administrafiive�olky. It shati be the sespons�bitil�►of the applicarr� owner,ocsuparn or user to perform standard mairrtenance of the searer service line from the premises to the main includi�c�bris deaeiag w root cutting and to mairrtain#he water service curb stop box for operability and at such heiglrt�wiq ensure that it remains above#�e finishec grade of tfie tand or property. (Ref 638,1156,1141)