Meter Swap # `
` Request Number: 12951
Public Works Division
Service Request
Problem Address: 1327 75th Ave Requested By: Norm Iverson
Department: WATER Address: 1327 75th Atie
Fridley,MN SS432
Problem/Issue: INSTALL AMR METER Phone Nnmber: 763-786-3274
Sc6edule e: 201 -01-2S � Scheduled 11me: 10:30:00
�LJ ��1•
_ , ACIION NEEDED:Install AMR
Created by: Beth Kondrick Date Created: 2017-01-19
ACIION TAKEN:
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Shtus: 1x►Progress S�tbmitter H�Been �.,
CoMacted
Date Completad: ,�-a5— �� Completed by
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1r11/ater i�e�artrnent
�431 Urs6v�rsitv�Avenue N� ��.� �Sv���.���
� ' Fridley,MN 5S4.3Z /
, 7�3-572-3566 �� �
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hereby autForize the�'rty�f Fridley and/or i�s emAiopees to�io what is necessary to
repface#he water rneter. 1 understand that#he proper#y owner as liable for the avater line from 4he cnain to the premise and a!1 interior
plumbing. {Per City code 402.06j i also hold the Cfij of Fridley and/its employees harmiess#or eny damages titat may nccur white daing tEfis
operation. Tfiis to 4nclude,bufi not lim�#ed to valves,piping,walis,floors or xhe curb stop box and service line. In understand!am also require�
to obtain a permifi pr'sos to ariy�ror{c,if necessary,
FIl11AL METER READIAiG toid meter) �P�� � �
Name:!��� �LM���'�" Addre� I��� /�� `��i
Phone Number��� v�(�l9 '3� /-) p� 1�',a�j � l?
Signature Witness Signature
C1LD METER#_p"��� y l��
OLD READtNG_ 7�� � � �
F1iEW METER# ��6 I �� �(Jv
NEW READIIVG �
ERT# � V� V � �OVJ� .
FRIDLEY CIT1f CODE
CHAP3ER 402.WATER,STORM WATER AND SANITAitY SEWER
ADMtNIS7'RATIOAt
(Ref Ord No 113,464,565,566,624,638,662,9Z2,988,1144,1156,1191j
402.5 PERMIT FEE
Prior#o constructing or repair of any water of sewer line connecting the existing municipal system and arry house or building for whicf�tfie
app(ication is made,the owner or corrtractor sha(f be required to nbtain a permit for such coonection,and shall pay a permit fee as proMded in•
Chapter 11 of this Code. After such connection has t�een made,the Water and Sewer Department shall be notified, it shall be un(awful to cover
any connecting Gne untii an inspection has 6een made and such cQnnection and the worbc inaderrt thereto fias been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAIfYTENARICE 70 CONNECT'ION
After the initia[connection has fieen made to the water service curb stop box or the sewer lead at the property iine or a water service lead has
been extended to the praperty Iine for connection,the applicarrt,owner,or accupant or user of such premises shall be lial�e for ail repairs
required to any water I�ne and sewer lines necessary for connection of the premises from the main fio the prem'�s. ff the property owner
requests main#enance service or repairs be performed by the C'[ty,the property owrter shail be charged for the costs af the mairrtenance andJor
repairs,including necessary street repairs at a rate set annuaify by an administrative poliry. It st�att be the responsibil'�ty uFthe appiicarrE,
owner,occuparrt or user to perform standard mairrtenance of xhe sewer service line from the p�emises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that�t remains above the finished
grade nf the land or property. (Ref 638,1156,1191)