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Meter Swap . ' Request Number: 14253 Public Works Division Service Request Problem Addreas: 6381 Squire Dr Requeated By: Jamyang Te�ar Departmeat: WATER Addresa: No�ess providcd Problem/Isaue: INSTALL AMR ME'IER Pha�Number: 571-901? Se�dtile e: 2017-03-29 � Sc6edaled 1lme; 08:00:00 r � ' �-� � AC7ION NEEDED: Created by: Wendy Hiatx Date Cre�ed: 2017•03-22 ACIION TAI�N: L�.s� �1 ��-( � Status: In Progcess Snbmitter Hae Beee � Co�acted Date Completed: Completed by: � - Z°I- � 1 T k�- � , � �,�ii .� � � ���7�- �-�.� ' City of Fridley � Water Department � �j ��� 6431 University Avenue NE Fridley,MN 55432 763-572-3566 I/we hereby authorize the City of Fridley andJor its employees to do what is necessary to replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all iriteriw plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaau while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. in understand I am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) �� � ��� Name:� �Address r � r Phone Number � Date_ cJ�� i' / / . � Signature Witness Signature OLD METER# V ►S� J 2 2C� OLD READING ��� � `f Q NEW METER# i� r O��� 1 NEW READING O ERT# � l �J r r✓� � 1 FR{DLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of s�wer tir�e tonnecting the existing municipaf system and any house or buiiding for whid�the appltcation is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer qepartment shall be not�ed. It shall be unlawful to cover any connecting{ine until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 4U2.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water serv;ce curb stop box or the sewer lead at the property line or a water servke lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repafn requPred to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property oMrner requests maintenance service or repairs be performed by the�ty,the property owner shall be charged for the costs of the mair�tenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It sfiatl be the respor�sibility of d�e applicarit, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)