Meter Swap ` Request Number: 14171
Public works Division
Service Request
Problem Address: 6360 Squire Dr Requested By: Gigi Holmes
Depxrtme�: WATER Addresa: No adchess provided
Problem/Issue: iNSTALL AMR METER Phone Numl�er: 574-9193
Sc6eduled Date: 2017-03-21 Scheduled T1me: 07:30:00
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ACIION NEEDED:
Created by: Wendy Hiatt Date Created: Z017-03-17
ACTION TAi�N:
Status: In Progress Submitter Aa:Been r.
Contacted
Date Compteted: Completed by:
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��ea�tiors_ �'Pais���ci�c��,�a�t recm 8aa�s�tec!�ca walves,�alpirog,�raJis,f9�ors or tfee�r8a sto���rnc ara�i seavece liaee. ar¢uasd�rstanrt d am aL<
tsx o&a�aira a percnit�ar3o�r�ce aaay�rne'�,a'F�secessaryv
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4Q2.5 PERtMld"�"FEE
Prior to constructie�g or�epair af ariy water aF seurer�iaae connecting the aas�asrg muniagal systeer�and arry€�ot�se os bu7dPng for urhich#F
agpficativn is sasade,filae cnvr�er oc confiractflr shatl(ae requ�red to ohtain a perrrs�for sucfs wrmection,and siaalt Aay a permfi fee as provs
Cha�rCer 3.�vf�his Code. Afi�er saucfi connectio�has�ee»made,the U6Fater and Sewer De�rrarCmerrt shatt�e�aofified, �shatl he unfawfui t
aray cvnnecting�ine urrta7 an ins�aectiore�aas 6een,made and such conaection antf the wvr�r inciderrt theretc�has been aPtxoved by�tEte C'ity
proper and suitab(e coneaQctios�.
�02A6 �iEPAiRS At0{��tAlN7'E41[AyVCE TO Ct�1M4otEC7'i041t
,�er the ini#ial sonneetion t�as been made�o ihe�rrater senrice curb stop 6ox or�tite sewer�ad art�fse pmperty line vr a waier seroice lea�
bee�e�entted�o�fre pr�operty line for son�ect�ar�,the appiicarrt,aarrner,or accu�arrt or user of such prernises shati be i�a�e far aR repatr.
require�d�to ar�a�rater line�nd sewer lines necessary#or connecti�n aF fihe�remises from the main to the prem�ses. ff the property orvraei
a�equests ma�rr�enance service ar repairs be�erformed by the City,the�rope�:y awner shall be charged fior#he�osts of the mairrtenance a
s^epairs,indudirag necessary street repairs at a rate set annualty iry an adminis#ra�iwe policy. tt shatl be i�e respons�itityi aFthe applicarrt,
o�,vner,�ccu�rarrt car user to perForm standaaX!mairrt�r�ance vF tt�e sevrer seraece�ine frvm�fse premisss to ifie main aacludirig debris de�arir
root�a�tting ar�d to mairrfiafn the water serui+ce curb st4�bo�c for opera�itity and at su��eighfi as artli ensure t�at tt remains above the fini;
grade of the�and or prv�erty_ �t�ef 638,2156,1191�
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City. of Fridley
Water Department
Address � t� �01/ are
Name �n�t�LS
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�ate �.D'G7 -�S 6
Old Meter Number [ � a 2�
Old Meter Reading � ��
Replacement No. �J� ��60 �
Replacement Reading _
Replacement Make �q.�-9�r _ __
Remarks• u�' <'���
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S igned ���. '� +