Meter Swap ..
Request Number; 16515
Public Works Division
Service Request
Problem Address: 5920 Stinson Blwr.l Requested By: Sue Spencer
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-574-2286
SchednledDate: 017-08-09 � Scheduled'Iime: 11:30;00
, 1�
ACTTON NEEDED:
Created by: Wendy Hiatt Date Crented: 2017-07-31
ACT[ON TAI�N: �
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
Hours �"j"—' `0,�--
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�i�of��aetley �j��"' '' ��������
. i i�4/ater�epar�enerot S� ��, /'
fi43�.University Avenue iV� �y
Frisll�y,MIV 55432
763-532-3566
�A'"�e hereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. !understand#hat the property owner is{iabfe for the water line from the main to the premise and all irrterior
plumbing. {Per�ity code 402.06j 1 also hold the City of Fridley and/6ts employees harmless#or arry damages that may occur while doing Lhis
operatian. This Lo include,but not limited to valves,pipirtg,wails,#loors or the curb stop box and senrice iine. in understand i am also require
to obtain a permit prior to any wark,if necessary.
FIIWAL METER READING{old meter} � l � ��� O
P1ame: �v� � �.v�/`� Address _ � K ) ( ,����0 � � �ls�
Phorte 9Yum (1������"'�-2'�� �� r 1,� l�
�Signature d!litness Signature
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OLD 3ViETER# ���/ � 1�
oLD ��,D�NG � I v3 3� �
NElA/91IiETER# b I�� � (J��t--
NE�AI READtNG�
��T� _ `��� I S� �� .
FRIDLEY ClTY CODE
CFIAE�TER 402.WA7"ER,STORM WATER ARID SANITAItY SEWER
ADMINISTRAT{ON
(itef Ord No 113,464,565,565,624,638,662,922,988,1144,1156,1191)
402.5 PERMi7 FEE
� Prior to constructing or repaic of arry water af sewer line connecting the existing municipal system and arry house or buiiding for which the
appfication is made,the owner or contractor shali be required to o6tain a permit for such connection,and sfiaii pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. it shal(be unlawfui to cover
any connecting line umil an inspection has been made and wch connection and the work incident thereto has beert approved by the City as a
proper and suitabie connection.
402.06 REPAiRS AND MAIN'1'ENANCE TO COAINECTiON
After the inifiia!connection has been made to the water service wr(�stop hox or tfie sewer tead at tfie property line or a water serv�ce lead has
been extended to the property line for connection,the applicant,owner,or occuparit or user of such premises shall he liai�(e for al[repairs
required to arry water line and sewer{ines necessary for connectiort af the premises from the main to the premises. If the property orvner
requests mairrtenance service or repairs he performed by Che City,the property owner shall be charged for tF�e costs af tbe mairitenance and/ar
repairs,including necessary street repairs at a rafie set annually by an administrative policy. It shall be the responsihility vf the applica�r►t,
owner,occupant or user to perform standard maintenance of the sewer ser+rice line from the premises to the main inctuding debris clearing or
root cutting and to mairnain the rarater seroice curb stop box for operahility and at such height as wiil ensure that it remains above the finished
grade af the land ar property. (Ref 638,1156,1191)
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City of Fridley
wat-- er De,�ar._ t_ m`
Address �''�j �'�, ` .
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Name t �I�/—U�'tt-'.'�
Date .� 1/1
v
" Old Meter Number �
Old Meter Reading
Replacement No.
c
Replacement Reading
Replacement Make ��-�t?�
Remarks: � � ��-� � ��
Signed
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City af Fridley
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Ad�eas: 5920�TINSC}N BLV[) C�ae!€Rhone: 763574�
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