Meter Swap Request Number: 13100
Public Works Division
Service Request
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" � Problem Address: 1350 69th A�e Requested By: Sandra Bacon
Department: WATER Address: No address provic�d
Probleni/tssue: INSTALL 'IER P�ne Number: 571-3425
5chednled Dstte: Z -02-03 Schednled 1ime: 11:00:00
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ACTION NEEDED:
Cre�ed by: Wendy Hi�t DAte Created: 2017-01-Z6
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Stntu6s: In Progress ��►�tter Hu Been �
Coutacted
DAte Compteted: Completed by:
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�rvatea-�par�trnent � . --7
. �6431 iDnHvea-sityr Ave�ue NE -� `� .�:�=5 � l ,
� ` Fridley, M61( 55432
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. , ,s3-s�z-3s�6 �j �- —S7�)a.3u-c�
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��,�e her-�by authorize the�t'riy srf Fridley andjor its empioyees to alo what is necessaey to
repiace+the water rneter. 1 understand that the property owner�s diable for the water line from the main to the premise and all irrterior
plumbing. (Per City code 402.06) i also hold the C'rry of�ridtey andrfis employees harmiess#or any damages that may occur rrhile dotng this
operation. This to 9nciude,but not limited to aalves,p�ping,walis,floors or Lhe curb stop box and service line. In understand 1 am also requir
to obtain a permit prior to ar�y�erorlc,�f necessaey.
FIAtAL METER READtNG(old meterj
Name: Address i 3�� — c0 % ���-
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Phone►Mumber � a 3-►�
Signature Witness S'rgnatvre
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o��nn�R�— 5 6 � 1�7 3 J
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OLD READING
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IIiEW METER#,^' �,�7312 '—"
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NEW READING �
ERT# � I �� � � $� .
FRIDL.EY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
aonn��uisrRanon�
{Ref Ord No 113,4G4,565,566,629,638,562,922,988,1144,iS56,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of�wer line connecting the exis#ing muniapai system and arry house or buiidir�far wbich the
appiication is made,the owner or contracto�shatl be required to obtain a permit for such c�nnection,and shall pay a permit fee as provided irt
Chapter 11 of this Code. After such connection has beea made,the Water and Sewer Departmertt shail be not'rfied. tt shaii be uniavrful to cove
arry con�ecting line ur�til an irispection has been made and such connection and the worlc inaderrt thereto has 6e2n approved by ihe City as a
proper and suitabte connedion.
402.06 REPAIRS AND MAINTENANCE TO COMNECTION
After the initiai connec�TTort has been made to the wate�senrice aarb stop box or the sewer lead at the property iine or a w�r seroice tead tws
been extended#o the property line for connedion,the appiicarrt,owner,or accupant or user af such premises shati be Rabie for all repairs
required to any water tine and sewer Ifnes necessary for connection of the premises from the main to the premises. tf the property o�rner
requests main#enance service or repairs be perEormed by the City,the properityy owner shatl be charged for the costs of the mairttenartce and/or
repairs,including»ecessary street repairs at a rate set annually by an administrative policy. It shali be ti�e responsbilitr of the applicant,
owner,occuparrt or user to perform standard mairrtenance af the sewer service line from the prem+ses to fihe main inciuding debris dearing or
root sutting and to mairrtain the water service curb stop box for operability and at such height as wiii ensure that it remains above the finished
grade of the land or property. �Ref 638,1156,1191)