Meter Swap , Request Number: 13053
` Public works Division
Service Request
Problem Address: 1419 W Danube Rd Requested By: Ywnne
I�epartment: WATER Add�.ess: 1429 W Danui�e Rd
< Fridley,MN 55432
Problem/Issue: INSTAL,L AMR METER Phone Number. 763-502-2330
Scheduled I�te: 2017-01-30 Sc6ednled 1lme: 11:30:00
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ACIION NEEDED:Install AMR
Created by: Beth Kondrick Date Cterted: 2017-01-24
ACTION TAI�N:
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Status: In Progress Snbmitter Has Been r,
Contncted
Date Completed: `� 3�`— 1� '�} Completed by: ����
Watea-�epar�a�t�ent
5431 Untversii�//�veeaue PlE Y�
Fridley, MN 55432 �a-��� /�� �� �
753-5T2-3566 L� � j � �
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9,"�� her�by authorize the City of fridley and/or its empioyees to slo what is necessary to
F replace#he water meter. �understand that the property owner is liable for the water line#rom the main to the premise and a11 iMerior
plumbing. (P�r Crty sode 402.06j i aiso hold the City of Fridley and�fis empioye2s harmless#or any damages that may occur tirhile doing this
operatian. This to 6ncfude,but not limited to valves,piping,wails,floors or the curb stop boz ar�d service line. In understand!am also require�
to obtain a permit prior to any wor�c,if necessary.
FlNiAI METER READING(oM meCerj �`-"��� ��
Name: L 'U(�Y11�1 Q Address_ � 6 4 l � �Cl.✓I,W�� .t�--� .
Phone Number��� ^` � � 2 ?j' v p� �,���� � � I
Signatu�e Witness Signafiure 1�
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OLD METER#
35 �� 5�� ,� .
OLD READIlUG_���� �OO
NEW MEPER# �� `� �� ��
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NEW READING � �}
ERT# � � � � � � v7 .
FRIDLEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMiNISTRATION
(Ref Ord No 113,4G4,SfiS,566,629,G38,662,922,988,1144,1156,1191}
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer 6ne connecting the existing municipa[systesn and atry fiouse or buiiding for which the
application is made,the owner or contractor shai(be required to obtain a permit for such connection,and shall pay a permii fee as provided in•
Chapter 11 of thes Code. After sucfi connection hes i�een made,the Water a�d Sewer Department shall be notified. ft shall be uniawrful to co��
any con�ecting line uritil an inspection has been anade and such con�ection and the work incider►t thereto has bee�approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO COPtNECT10N
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 Iead has
bee�extended to the property line for connection,the applicarrt,owner,a�accupac�t os user of such premise�s shal{be 1'saMe for ail repairs
required to any water line and sewer lines necessary for connectian of the premises from the main to the premises. ff the property owner
requests mair►tenance service or repairs be perFormed by the C'rty,the property owner shall be charged for the costs of the mairrtenan�e and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative policy. Ft shatl be the responsibil'ety aFthe appiicarrt,
owner,occuparn or user to perForm standard mairrtenance of the sewer service line from the premises to the main i�cludi�debris dearing or
root tuttiag and to maintain tfie water service curb stop box for operability and at such height as will ensure that it remains above fihe flnished
grade of the land or property. {Ref 638,1156,1191)
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�k.����s� ���sl''��' �.I /��Mr�t r� t""�;.
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Na�e ��a��� �c�c �[Po�' _
Date �'�`�
Old Meter Number� � � , r ..0 �
Old Meter Reading
Replacement No. 5�
Replacement Reading C�'
Replacement Make � �`'^ _,.,
R�marks: � L(;� 7a��
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Signed