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Meter Swap Request Number: 12769 ' . Pubtic Works Division Service Request Problem Address: ?360 Pine Tree Ln Requested By: Ricl�rd Dots(Neighbor) Department: WA'IER Address: No address�ovided Problemllssue: INSTAL,L AMR N�TER Phoee Namber; 763-786-6294 Schedaled Date: 2017-01-12 Sc6adelad Tlmc: 07:30:� c� �`' : 3 ACTION NEEDED: Created by: Weady Hiatt Ilate CreARed: 2017-01•09 1 ON TAKEN: � I�. 1..�...� �. y . . ....... . . . � States: 1n Progress �b�itter HAs Bceg r Contnctad Date Cem�etcd: Compietc�by: �� ��� �� ,.: , �� . .� City of Fridley J Water Department � (� ( � �� \f 6431 University Avenue NE Fridley,MN 55432 `�� 3 ,� )''��-�c) �� 763-57Z-3566 �EWe hereby authorize the City of Fridley and/or its empioyees to do what is necessary to replace the water meter. 1 understand that the praperty owner is liable for the water line from the main to the premise and all i�erior plurrebing. (Per City sode$02.06) i also hold the City of Frid{ey andJits employees harmless for any damages that may ocwr while doing this operation. This to incfude,but not limited to valves,piping,walis,floors or the curb stop box and service line. 1n understand f am aiso required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) � � � ` �� � Name: L.�<<.��c� � �s Address_� ����� �I �,-�_�'f'T ���,_ Phone Number ' �_`J'�� •C�D� � ^ L� '� � Signature � � ' Witness Signature ��^�� ���"�"` .. OLD METER#_ � z--�� 4 _I �� - �Y ���;x `. �+�- - � ..� G , -; OLD READtNG �'�� �"'I � �Z..� �'�^'+f�. t���,� �=~ �'� � � �?�:l-�� t�� 'e'`�`� '�'� ; NEW METER# ` ' � �Gul�ce-z"�/'�"'Q'/. _ �� '� NEW READING � ��''"'� �'`" `� ____ ___ _ _�.� ERT# � �� '� �� FRtDLEY CITY CODE CHAPTER 402.WATER,570RM WATER AND SANITAltY 5EWER ADMIN{STRATION (Ref Ord No 113,464,565,566,629,638,662,92Z,988,1144,1156,1191} � 402.5 PERMIT FEE Drior to constructin�or repair of any water of sewer line connecting the existing munkipai system and arry house or buitding for which tt� appiication is made,the owner or ca�tractarr shail be required to olrtain a permit for such connection,and shalt pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shal!be unlawfut to cover any connecting tine unti{an inspection has been made and such connect+on and#he work incident thereto has been approvec!iry the City as a proper and suitable connection. 402.06 REAAIRS RPID MAINTENANCE TO CONNEC'TION After the initial connection has been made to tfie water service curb stop box or the sewer lead aC the property line or a water service lead has been extended to the property line for wnnection,the appllcarrt,owner,or accuparrt or user of such premises shali be IiaWe for all repairs required to any water line and sewer lines necessary for con�ection of the premises from the main to the premises. If the property owner requests mai�tenar►ce senrice or repairs be performed by the City,the property owner shalt be charged for the cos�of the snairrtenanae and/or repairs,including necessary street repairs at a rate set annuaily by an administrative policy. It shali be the respoosibiiity of the applicarrt, owner,occupant or user to perform standard maintenance of the seYwer service line firom the premises to the main inctuding debris dearing or root cutting and to mairrtain the water service curb stop box for operabifity and at such height as wilt ensure that�t remains above the finished grade of the land or property. (Ref 638,1156,1191)