Meter Swap � Request Number: 13775
Public Works Division
Service Req�st
Problem Address: 6480 Squire Dr Reqnested By: Gary
Departmcat: WA1ER Address: �$0 Squire Dr
Fridley,MAi 53432
Problem/Iasuez INSTALL AMR ME'1FR Pho�Number: 763-374-9679
Sc�ednled Date: 2017-03-20 Sched�led Ti�ae: 09:00:00
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AC7TON NEEDED:
Creatad by: Beth Ko�ick D�e Crertad: 2�t 7`-03-02
ACTION TAKEN:
Statns: In Progress Snbmitter HAe Beee �,
Coetacted
Dste Completed: Completad by:
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!/�ae laere6y asaghorize ttlse C' �#�r�d1
�ega9ace�e�a�er megea�_ g�ancEerstaetd t�sa��tae ro e � eg and/ae-its ernpioyees to s!o w�at ds necess
�+ P �Y�+ner�s�iable#or�fil�te�rafier lie�e from the snain to�ae premise and all iaiterio�
� �faaaralsieag- {��r�C'ity coa9e 4�2.�� �a8sea�aoi+d�e�'s�j+��sidley and/Sfis�m}al�ye�s 9�asmless for em�/flamages�eat e�e�aay�ccur 3u4aile s�oir:
. �aerat5ors. �'9ais Yo�nePucEe,�aca�soo�C das�a�ste�(�o wahres,�iF�ng�vadfs,f4�ors or#:i3ae�a.cria sto�a�aox aead serv6ce fis�e. Ira understand�am aiso
tca oiataira a perrni��Or"sar to any rrnr�,'sf�secessar�j_
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FR[�LE�l CI�Ct�DE
CIiA►�'fit 4UZ.WA7'El�,STO�W��'ER AND SAN�t'At�YSEWER
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Prior to constructing or�-epair of ar�y water aF sewer 9ine connecting the�cist�ng rnunicipal sgstem end arry�nouse or bui[ding for wfiich the
appt�cati�n is made,�he owner or corrtractor shatl be required to obfiain a permit for such�nnection,and sf�all pay a permii fee as providE
Chapter 3.2 of this Cade. After suc.ii corrnection has been rnade,the Water and Sewer Departmern�talt�ie natifi'ed. tt si�al!be urt�aarfut ta
ar�y cona�ecting Cne urrtil an inspection has been anade and such connection and the wor�r inciderrt#hereto has beere approved by fihe�-cty a
pro�oer and su�tabte cc�nne�tio�a.
402.06 �tEPA�1R5�1R{D�tiA(l1fTENANCE TO��tECT1�R(
After the initial sonnection has besn made to#he wafier service a,rb stop box or�e sewer fe�at the propertY�ine or a water sernic�e�ead
been exteraded to fihe property fine#vr connectian,�e appiicarrt,owner,or accuparrt or�ser af such premises sF�afl be 1'iabte for all repairs
require�!to arry water dine and sevver lirtes necessary for connectivn of the prem�ses fram�e main to the premises. if fihe pro�rly owner
requests mainternance senrice vr re�rairs be perPormed iry the C'rt1l,#ae�roperty owner shali f�e charged far fihe�osts af ihe mairrtenance an�
repairs,inctudirag ne+cessary street repairs afi a rate set annuaify by an adnninistrative policy. it s6a8 be the respor�sbii'rty o#the apt���,
cnvner,occu�arrt or user tv perForm sZandard dnairrteriance of the seurer sererice line from the premises to�the main dridu�rig debris dearing
root�catCing and to maimain the uvater servir..e curb stop box for operabiiity anc�at such height as wi(1 ensure that it remains above the finisla
grade aF the land or prvperty. �t�ef 538,2155,1191)
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� City of Fridley
Water De,�artment
Address � 7 c� '
Name �� �.c�q�3.�;��C.
Date g ` ,��- Q �
Old Meter Number � ��
Old Meter Reading 6 3 ��
Replacement No. � 7��,.�0"
Replacement Reading (�
Replacement Make �c.�t.
Remarks• ,' ,,¢�.e,/
Signed �