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Meter Swap � Request Number: 14265 Public�Vorks Division Service Request Problem Address: 1450 Trollhagen Dr Requested By: Richard Department: WATER Address: No ad�ess provided Problem/Issae: INSTALL AMR METER Phone Number: 572-0592 Scheduled Dxte: 2017-03-28 Schedaled 11me: 08:00:0(1 -.--- �✓ 2�� r,-, ACTTON NEEDED: . Created by: Wendy Hiatt Dxte Created: 2017-03•23 ACIION TA�EN: _ � �Vl, 1 �� '� _._.._�......_�_....�.�.__._._.._...._ ...__!_..._.........._....__ _..__.__._ �{� �� _.._ .._... _.._ __.._._._...._...... _ '�.' � 5tatus: In Progress �bmitter Haa Been r. Co�acted Date Completed: '3—a���� Completed by: ��k„� �� �� �'' -� ��� �-�.J�'��,� _ Z�� �� ��� � �4 �: � City of Fridley Water Department 6431 University Avenue NE Fridfey,MN 55432 763-572-3566 �/We hereby authorize the City of Fridley and/or its employees to do what is necessery 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 iMerior ptumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may ocp�r vrhile doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required to obtain a permit prior to any worfc,if necessary. FINAL METER READING(old meter) � �� � �� Name: _ �+��r �(/1�r� Address 1��� �V� �I. �e n r� Phone Number ��� ` �� t p� Date_ J" �v � v ` � Signature Witness Signature OLD METER# ��v � �`�' OLD READING � ` � J O � NEW METER# � U�� l I�� NEW READING � ERT# � �� ����� FRIDLEY CI'�Y CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMfNISTRATION (Ref Ord No 113,464,565,566,fi29,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or building for which the appiication is made,the owner or contrador shall be required to obtain a permit for such connection,and shali pay a permit fee as provided in Chapter 11 of ihis Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to dbver any cflnnecting line 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 connedion. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has been extended to the property line for connedion,the appiicant,owner,or occuparrt or user of such premises shali be liabie for all repalrs �equi�ed to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests mairrtenance service or reqairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shaN be the responsibitity af the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including 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)