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Meter Swap Request Number: 15219 ' Public works Division Service Request Problem�ddress: 60 70th Way Requested By: Na�y Department: WAZER Address: No address provided Problem/Issne: INSTALL AMR METER Phone Number: 571-4612 Scheduled 2017-OS-11 � Scheduled'Dme: 08:00:00 ACIION NEEDED: Created by: We�dy Hiatt Date Cre�e+d: 2017-OS-08 ON TAI�N: � .�-��,�� - s �.......... ._....... .._.�..�. . �.�.•.�••-•...�...__.�....._. �,.,.._ � . Ststus: In Progress Submitter Iiaa Bees �., Contncted Date Campleted: Completed by: S= �1 -- I-1 7� f or � �� - �6� ��'a -� � „ City of Fridley � � Water Department � �� ' 6431 University Avenue NE Fridley, MN 55432 763-572-3566 ��We hereby authorize the City aF Fridley andior its empioyees to do what is necessary to repiace the water meter. 1 understand that the property owner is liable for the water{ine from the main to the premise and aii iirterior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur whife doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service fine. In un�rstand i am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter)� t�l ) �� Name•!v Q Address �V ' t�. �-I ,�� ' -� Phone Number� � Date I� � Signature Wkness Signature OLD METER# i��(/�$2 OLD READING V �V 1s7 � � NEW METER#_'�[ /J- I�tJ �d�� NEW READING � ERT# �� 21D � � FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND 5ANITARY SEWER ADMiNISTRATfON (Ref Ord NO 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existfng municipal system and any haase or butiding for whtch the application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permtt fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departme�shall be notified. It shall be unlawful to cover any connecting line untii an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 40Z.06 REPAIRS AND MAINTENANCE TO CONNEC170N After the initiai connection has been made to the water service curb stop box or the sewer lead at the property ifne or a water service lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs required to arry water line and sewer lines necessary for connection of the p�emises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the Cityr,the properCy owner shali be ch�rged for the costs of the mai�rtenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applica�rt, owner,occupar�t or user to perForm standard maintenance of the sewer service line from the premises to the main including debris dearing o� root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that k remains above the flnished grade of the land or property. (Ref 638,1156,1191) F �� D`�',��,�� I city of Fridley Water Det�artment Address V V 1 � � � � Name � � Date ,�— �,��a Old Meter Number � � Old Meter Reading �( D � �� Replacement No. f7 �� ` �� Replacement Reading � Replacement Make �� "Q'r --- Remarks- Signed �' ; Request for Senrice Repart City of Fridley Reference No: 601-11-3097 Date: Q6I07111 Request Type: Turn waker offlon Entered By: Wendy Hiatt Department: Water CitizenName: NancyAyu Address= 60 70TH W,atY NE v�� Callback Phone: 763-571-4612 Scheduled Date= 06107111 10_00 AM � Property Owner: Location Details: Permit# ,�(1—G�O� �2 Request Details= Turn waker ofF "`xxBILL'x"' Action Taken: ....... .......... . _ �____________.. ..��______, .._____-- �_.�_._.....______ ___........... ...�..__. /� . C-�- ��'�' �-�i, l.✓4'S 1 � � �' 1 I/t �k'r t� •�tr► Cohe.rc. �� . ��or�e. ot�•r�� + a � � 5 <<�;ori o � i �j �r�yt l,va � c � o� '� s�✓ + o �'�, J� � � � Y � g C �,i4 Y f"l,� ��tt o �.� o,� 6 _ $ - � �. � �t �Qa uP ,�c x �- ��. r � Fiesponsible Person: `J� • a Approver: � , , Completion Date: � TI �^T �itizen Notified I � � � � �