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Meter Swap .,- � ' Request Number: 12804 Public Works Division Service Request Problem Address: 1503 73 1/2 Av�e Requested By: I.croy Larson Departmeat: WATER q�.CBS. 1503 73 1/3 A� Fridley,MN 55433 Problero/tssue: INSTALL AMR ME1ER Phone Number: '763-784-0899 Sc6eduled Date: 2017-01-19 Schednled Tlme: 10:00:(!0 � AC'IION NEEDED: Cretted by: Beth Kondrick Date Cre�ed: 2017-01-09 ACTION T . ��c��1�; � �.___�._._.�.. � M : Statua: In Progress 5nbmitter Has Bees r. Contncted Date Completed: Completed by: I � � � � I '.s ~ ,r''� �,,,"''"�� ._y �...��'�.�,--�..;.:� --,�.- � �_.._... � ,r� City of Fridley �(J� � � C� � Water Department / 6431 University Avenue NE .c� ��j�1 ?r� 'v 1 � Fridley, MN 55432 7�� 763-572-3566 �/We hereby authorize the City of Fridley and/or its empioyees to do what is necessary to reptace the water meter. 1 understand that tfie property owner is liable for the water line from the main to the premise and aii irrterior piumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to inciude,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required to obtain a permit prior to any work,if necessary. FiNAL METER READING(old meter) I � � � � � �`3 r�'� Name: v � Address ��V � �l\1� �V '� Phone Tlumber�� `c.� 1�� Date �-� l�.r � � Signature � Witness Signature �� OLD METER#_� �� I �J� CJ� . OLD READING � J � � � � NEW METER# y�I I�� f , NEW READIN D ERT# � � �� FRIOLEY CIT1l CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINI5TRATION (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 existing municipal system and arry house or building for which the appiication is made,the owner or corrtractor shaii be�equired to obtain a permit for such connect'wn,and shalt pay a perm�t fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be uniawful to cover any coanecting line until an inspection has been made and such connection and the work incideni thereto has been approved by the City as a proper and suitable connedion. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initiai connection has been made to the water service curb stop box or the sewer lead at#he property Iine or a waEer senrice lead has been extended to the property line for connedion,the applicant,owner,or occupaM or user of wch premises shali be Ifable for all repairs required to any water line and sewer lines necessary for connectioa of the premises from the main to the premises. ff the property owner requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mai�enance and/or repairs,inciuding necessary street repairs at a rate set annualfy by an administrative poliry. It shall be the responsibility of the applicaM, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris ciearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191j ��qu�st f+ar�r�ic� Ft�f�a'rt Ci�y t�rf �ridk�/ � �� -�2� ��: �torzc��z T�� a�r�vr�n��t_� �: . �r� �e�� r� Ad�= 1�i T31l21►'�/E 1� . 763-�84-Z109 Siir�d O�e= 2�'1��11��Ni t3��r�er_ �� l�r�a�e�".�ai F�d€.eaEc and Requ��: �'au c��tro�r yi a�bi�e ii��lal► �e s� T � I 1J`��1�~� r� JU��k;! ��f`�� '!� '�'�� '�� t�LL,.��r ; . .� i _ '�'��p/ ��1' �...______-=-;f�`��"" -----------------�_..._.....�_.._.._ �- � i_____.�___�___ __......_..._.._ _ _______ ___�_ _....�...._ � ��:� ��`�,��' �� ■ a�� _.�_ � _.___ �_�._a