Meter Swap " Request Number: 14587
Public Works Division
Service Request
Problem Address: 1500 Windemere Dr Requested By: Molly Lease
Departmeat: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nwnber: 651-208-Z032
SchedWed Date• 2017-04-13 Schednled Tlme: 08:30:0(1
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ACIION NEEDED:
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Created by: Beth Kondrick llnte Created: 2017-04-07
ACTION TAI�N: �
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Status: In Progress ���er H�Been �.,
Contacted
Date Completed: � — �7j � �� Completedby: \ a(�,,,
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�-�gelace the uwa�er rrae�es. ��ar�c9erstand id�a#�€ae ro e � e+l and/or its empiog�es to sio what ds neces
� t� �oavnes 9s�iable foa-�lae vvater 4ia���rom�he enais�to�ae premise ar�d ali iarteria
�faarrabirag. �Per�City�os9e�Z.�6� �ads��o9cf�e�'st��f�Fsedley and�S�ts�m}sl�,�e�s�aarmless�or amy�iarnages tiaat araay otcur jer#aite�oi�
, a�aeragiora. �4ais fics�nel�ac3e,4au$�aa��aaa�s'ted�o prelves,�;pirag,awatls,�l+�ors�s�tae�aarb sto�kaox and see•vdce lisee_ Irn�sesdersCand�am also
t�o&ataira a��nit�arso�r to aray�rnr�,sf r�ecessara�.
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witness signature
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Cti�'�QOZ.U�((�TEdt,SC�RlIP�1A/�,�R AND S�kAtii'ARX SEWEI�
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�Ref Card 8�1�9.138�+54,565,�66,629,6.',$,�6Z,�ZZ,9$8,11d�4,1156,1:E91j
402.5 �ER4Ufi'3'FEE
Prior to r.onstr�ctirrg or�-epair of any water of server firae�onnecting the eKisting rnuniapal system arid ar�/�ouse�^bu�tdirrg for whidt the
apptication is rnade,the owner or corrtractor shall be required to obfiain a permifi for sucfi connedaon,and staali pay a�rermr�fee as pro�rid�
Chatrter 3.�of this Code_ After such corrnectiarc has beer+rnade,fihe�11'ater and Sewea�Departm+errt shald€te sao�ed. tC shal!be unlawfut ta
ar�y�onnectang dine until an inspectivn has 6een snade and sucb connectiors and the vror�c inciderrt there#o I�as been approved by the�ity a
proper and suitabte cons�ectiora.
�tJ2A6 �iEPAlRS�.IMD�AIM'EA(A4dCE T�CONNECIi�
After the inr�Iaf sonnectian has been made�ihe water senrice curb stv�box or�e sewer tead at i�se propecty line or a waCer�rvice lead
been exfiended tfl ti�e property line for conr�edaon,fihe appiicarrt,rnrner,or accv�rar�t or aaser o#such premises sf�afl be iiabie fvrall y�irs
require�d�to any water dine�d sewer lines e�ecessary fiar connection vF the premises from the main to the premises. !f ttze proper[y owner
requests mairrtenarrce service or regairs be perFormed kry the CFt1+,ttae property owner shail be charged for the�osts o##be mairrtenance an:
repairs,includ"rrag ne+cessary street repairs at a+�afie set annualfy#�an adrninis�a�iwe pvliry. 1t shat!be the responsibiiirty*o##�e aPpr��,
cn�vner,occuparrt�r user to perform standard a�nairrtariance of fihe seurer serr+ice line from�te prem�ses to the main Sndudi�deb�fis ciearing
root c�ztfiing arad to mairrtain the urater seruice curb sfiop box for operability and at such iaeigFrt as arill ensure tha�t it remains above the finist
grade of the�and or property. (Ref 538,1156,1191j
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City of Fridley
Water Department
Address �sv� �-�" �1�����-
Name �i^,.v-G�n.�,�., ��"�`'� .
Date � � � �� �
Old Meter Number � � C �
Old Meter Reading � � 5 v
Replacement No. 7 � � 1.� Gf g ��-=—
Replacement Reading a
Replacement Make ���" ��
Remarks: � �°
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Signed
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