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Meter Swap , ` � I s 3 � �r' �I ,� "` cr�,��. Fridley � Requ�st Number. 17702 Pub�c Worka D�ion ;� 3ervke Re�est --_;. <�=— --- ---_____�—__ P`�Iem Address: 460 75th Ave Requested By: Psd w/Grace LuEherae Cburcb Deputment: WATER A�ddreaa: No address providod Probiem/Iss�: INSTALL AMR ME'IER P6one Nwnber: 612-554-7586 �� o��t;r� ;�,,. Schednied e: 2018-02-09 Schednled 1lme: 0�:00:00 ` � � M �'�:�, AC7ION NEEDED:AMR's � ,,:�3 � Crented by: Wendy Hiatt Date Created: 2018-02-06 _.�:�� ACIION TAI�'.N: 1 - '�v1,53�-G(�° c�. `�-� d G'��-�S . �,� ��t: � .. __ _.._.__.......__ .___.._._ ��,:: r,��; q,,�r�a�. Status: In Progress �i�mitter A�Been �., ;�� :tifr Contacted - ,,; Date Completed: Completed by: �� ::.; �" �^ � � �Gt, � �t`�MG 8' �. $�: . City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 Ijwe hereby authorize the City of Fridley and/or its employees to do what is necessary to repiace the water meter. i understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that ma�►occur wfiile doing this operatio�. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand i am also reqyired to obtain a permit prior to any work,if necessary. FINAL METER READING old meter v ��./ �-fi" �' "� ( � Name: ��iN Address ��V � � � �'e.. Phone Number �G« ' �� v� Date � � �— �� Signature_ � �� Witness Signature OLD METER# ��lo� i % J (,O SIZE & STYLE(Circiel OLD READING v l � G ��G 5/8" HEX NEW METER# � � ` t �� 1" HEX C� NEW READING � 1�" ELIPTICAL or HEX ERT# � �'"� -` � 1 � / t :,>: Z•, ELIPTICAL or HEX FRIDLEY C1TY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,�29,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buildtng fo�which the application is made,the owner or contractor shall be required to obtai�a permit for such connection,and shall pay a permk 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 unlawful to cover any connecting line until an inspedion has been made and such connection and the work incident thereto has been appro�red by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION 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 service lead has been extended to the p�operty line for connection,the applicant,owner,or occupant or user af such premises shall be liable for all repairs required to any water line and sewer lines necessary for connection 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 malMenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the ap ipnt, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding ris clearing or root cutting and to maintain the water senrice curb stop box for operability and at such fieight as wiN ensure that it remain bove the finished grade of the land or property. (Ref 638,�;156,1191) �t.,�,+.......,�.� • 5 � (��a-� City of Fridley �� ✓"� � � � �� Water DepaRment .a�/� 6431 University Avenue NE Fridley,MN 55432 763-572-3566 1/we hereby autlwrize the City of Fridley andjor its employees to do what is neoessary to replace the water meter. i understand that the property owner is liable for the water line from the main to the premise and all i�erior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this operation. This to include,but not limited to valves,piping,walls,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. F1NAL METER READING(ofd metery_ �v� / �" �� Name: �-"' Address ��v / J�� Phone Number `i/�'Z1 J��I'� �J V�pate 2� � � vV ��8n�i �� Witness Signature � OLD METER# �� v V� SIZE & STYLE(Circle) OLD READING V ��v �5�' HEX �✓ C� NEW METER# G � ` � ` � � 1 1" HEX NEW READING � 1 r4" ELIPTICAL or HEX ERT# `Z� �a�5 � � 2" ELIPTICAL or HEX FRIDI.EY GTY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATIOPI (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 whic�h the application is made,the owner or contractor shafl be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter li of this Code. After such connedion has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connectlon. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION 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 service kad 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 any water line and sewer lines necessary for wnnection 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 maintenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing 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 638,1156,1191) _. . :- s-��. ._ .__ _..� � /� ��3 � Cv�11�..=�j�-�lv ci�y of Fridley Water Debartment Address 1 4.t./ � � '^"�'1'C�`�= Name �,�cC�.. �...U�� .._�►��t'� -, Date �rJ�:'-c�"_'C..-� - �. �-a ["'� � Old Meter Number `;a�-�C `..� �_. --� ^ Old Meter Reading � J ' �:��-I �.�f�� Replacement No. ,...%� Replacement Reading � --- -�_( � Replacement Make ,��f ��J�-��.. Remarks: _��u.�C�+r'l�t"G ��'�� r-..✓}�'G�l.��w�� Signed � '� i � �,.