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Meter Swap � ' Request Number: 13156 Public Works Division Service Request Problem Address: 1523 73 1/2 Ave Requested By: Danieile Department: WATER Address: No address provided Problem/Isaue: INSTALL AMR METER Phone Number: 763-245-8477 ar�63-Z21-4148 Scheduled Date: 2017-02-0? � Sc6ednled 1lme: 10:30:M1 �-- � r� V� AC7ION NEEDED: Craated by: Wendy Hi�t Date Created: 2017-01-30 ACTION TAI�N: w ��,�c� � � � 1 � .______.......__:� .. . ...�......_.. _.r �atus: In Progress Submitter H�Been r, Contacted Date Completed: Completed by: .. '. � �� Z 1, I`Z Watea-�epartrrtent 6431 lDniversity/Aversue 6Y� 5 L !� �� / Fridley,MN 55432 � , L 753-572-3566 � � 3 d—� �� L'(�,' _� ; �/ ` 1/we hereby authorize the City af Fridley and/or its empioyees to do what is necessary to replace#he water sneter. 1 understand that�he property oarner is liable for the water line from the main to the premise and all interior pleambing. (Per City sode 402.06j i also hold the City of Fridley and/its employees harmtess for any damages that may occur white doing this operation. This to incfude,but not limlted to valves,piping,walis,floors or xhe curb stop box and service line. in understand 1 am also require� to obtain a permit prior to any�ror4c,if necessary. FINAL METER READING(o meter) � (, � � � �O Name• � "� � Address � l)�� v/�a � Phone Number�� U`�V ` {�"� ��/� �j'��J� ` Signature Witness Signa#ure OLD METER# r7 J�c_ � �s�G� OLD READtlVG [ J/? �I �O � D NEW METER#_��J 1'V� � y ' NEW READtNG O ERT# 1� 1,�J Y� �CJ�� FRIDLEY CITY CODE CHAPTER 4Q2.WATER,STORM WATER AND SANITAttY SEINER ADMINISTRATIOAI {Ref Ord ilto 113,464,565,566,629,638,662,922,988,i144,I156,i191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal systerrr arni arry house or buitdtr�g for which tl� epplication is made,the owner or corrtractor shall be required to obtain a permifi for such connection,and shall pay a permit fee as provided irr Cha�oter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt sha0 be notified. it shail be unla�aful to cover arry connecting line urrtil an irrspection has been rnade and such connection and the wor4c inaderrt thereto has been appro�red by the Gty as a praper and suitabte connection. 402.06 REPAIRS AND MAINTENANCE TO CONNEC170N 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 servic:e lead has been extended to the property line for connection,the appiicarrt,owner,or accupant or user of such premises shail be lfabie for all repairs required to any wa#er line and sewer lines necessary fvr connection of the premises from the main to the premises. If the property owt�er requests mairrtenance service or repairs be perFormed by the Crty,the property owner shall be charged for the costs o#the mairttenance and/or repairs,including necessary street repairs at a rate set annuaily by an adminiskrative policy. It shatl be the responsibility vF the applicarrt, owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris dearing or root cutting and to mairrtaia the water service�urb stop l�x for operability and at such height as will ensure that R remains above the finished grade of the land or property. �Ref 638,1156,1191] t' � � �c"' .� r�,"5 e - �r t 1;� t e `� :. 3�� h . �d{�� t °' , *�IF�� »n�,�w .�3��k �: �' u ' ........w. t �;x �'�� .,d,::. � � '``�;'� D�.te �1�� —.�------ Old Meter Number � �� Old Meter Reading g ReplacementNo• � I� Replacement Reading Rep�acement Make �� ERT# ,' Replacement ERT# 5 � �� ;VG`�� . Remarks: , Signed 1 �..r---T-' , � v' � � �� C�ty of Fridley Wat_er Devart�en � �73'��- Address � � � �— ��1J�ot� Name Date �l�� o� Qc� � �� VU Old Meter Number Old Meter Rea�ing 5 Q �S �a�`�� ReplacementNo• � " Replacement Reading . Replacement Make �-�� ERT# ,� Replacement ERT# Remarks: �� `M`�� Signed ,