Meter Swap ' Request Number: 13534
Public Works Division
Service Request
Problem Address: 5550 Regis Tr Requested By: Chucke Cooke
Depxrtme�rt: WA1ER Address: No address provided
Problem/Lsue: INSTALL AMR ME1ER Phone Nnmber: 763-568-4869
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Sc6eduled Date: 2017-02-23 Schedeled 1lme: 11:30:00
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ACIION NEEDED:
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CreIIted by: Wendy Hiatt Date Created: 2017-02-16 `
AC7ION TAI�N: �
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Statua: In Progress ���er Has Been r,
Co�acted
Date Compteted: �,,�i� ,..�y Com�deted by: ����
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�4�1 ilniversity�#�re�acae 6V�
Fradle�,delS�1 55432 O ��
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�j`A°� her�by authorize the Z'tety af�ridley and/or its erngioyees to s{o what ss necessary t
regslece the wa�er rneter. 1 e�nderstand Chat�he propea-ty owner ss liable tor#he water line from the main to ttee pre�nise and a11 irnerioe-
�►(ur►�tsing. (Per Crty�pde 4QZ.Q6� i adso hold the City of Fridley and/"rts em�O{oyees harmless#or any darr+ages that may occar ivhife sioing thi
opea�Yion. This#o�nclude,but c�ot lianiteci to vatves,ptping,wa(ts,f400rs or the ccerb stop i�ox and service lir�e. fn understand 1 am aLso requ
#o o�itaiea a pea�mit priaK ta any wor4c,�f�recessary.
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F9lYAL ARETER READiAi��old meter) �� ` V � O
1Yame:��ll�� �C�1�`e- Address _ ���� ���`$ � '�'
Phone 9�umber ��� "��� "��y .� a
_____.� a� _ �- a�� ��-�. -- .
signature w�i�s sig�a#ure ��
OLD MIETER#� �,���
OLD READi11iG� � ����
N����ER�_`�!��Q �7�7 �7 l
NEW READti1(G �
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�tifDLEY Ci"6'Y Ct)DE
CHAP4"ER 4U2.WAl'Eli,STORlW WATER AND SaNITARY SEWER
ApMI1VISTRATIOfrf
�Ref Qrd RNo 113,464,565,566,629',538,662,92Z,988,1144,i156,ii91)
402.5 F£RM17 FEE
Prior to constructi�g or repair of aay water a6 se�wer tirae connecting the existing munidpat system and arry house oc buitdirtg for which the
appls'cation is made,the rnvner or cvrrtsactor sha(!be requ�red to ohtain a permit for such connectson,and shali pay a permit fee as provided 6
�hapter 11 of this Code. After suci�connectio�i�as been made,the Water and Sewer Departmerrt shal!be naCified. tr shail be unfawfu!to cov
any connec#ing line unti)an inspectioa has been made and such connectian and the wrnic inaderrt thereto has been approved(ry i�e City as a
proper and suitabte connectiora.
40ZA5 l2EPAIRS AAID 1ViA11y'I'EfliqlyGE TO CONS�(ECI'ft)(oi
After ihe inifiiat connection has been made�the water servrce curb stop box or fihe sewer fead at fihe properiy ilae or a water service lead has
been exfiended to the property line foc connectian,the appiiprrt,oxrner,or accuparrt or user vf sur.h premises shali be liabie for aii reRatrs
required to arty water I�ne and sewer lines necessary for connettion af#he premises frvm#he main to the premises. ff the property owner
requesfis main#enance s+eroice or regairs be perFosmed try the C'ity,the propee�ty owner sha{I be c�arged for tfie costs of the mai�ttenance andJo
repairs,inciud?ng necessary street repairs at a rate s�t annually by an administrative policy. tt shail be tize responsbility o�f d�e applicant,
owner,occupant or use�to perform sfiandard mairrtenance o{the sewer service line from the premises to the main anciuding deb�s dearing or
root cufiCing and to mairrtain tfie water service curb sfiap box fo�operabiiity and afi such fieigfit as wiil ensure that it remair�s a6ove the finisfied
grade of the land or prvp�rty. �Ref 638,1156,1191)