Meter Swap �'
�
Request Number: 12896
Public Works Division
Service Request
Problem Address: 1319 75th Ave Reqpested By: Laaare
Depxrtment: WATER Address: No adc�ess provided
ProMemllissue: IN5TALL AMR ME1ER Phone Number: 763-300-3331
Scheduled Date: 2017-01-25 � Schedaled 1lme: 10:00:00
_� � �Ct
AGTION NEEDED•
CreAtedby: WendyHiatt DateCreated: 2017-01-17
AC'IION TAKEN:
t- �( �'+
_._.... � _ _.._-_--�-•-n-�-
�
St�tus: In Progress Snbmitter Has Been r,
Co��ted
�:��
Date Compteted: Cempleted by:
;:�
� � ^ � � �
� � � �
�b
�ny or rreaoey l)
Water De�artment �" � '� � `7 Tj
r 6431 University Avenue NE �
Fridiey,MN 55432 ��� _�
r 753-572-3566 �l�3''-S�
��'"6e hereby authorize the City of P�ic(!ey and/or its employees to do wfiat is necessary to
replace the water meter. !understand that the�roperty owner is tiab{e for the water line from the main to the premise and all i�erior
piumbing. {per City code 402.06) i also hold the City of Fridiey andJits empioyees harmless for any damages that may occur while doing this
operation. This to inciade,isut not limited to valves,piping,wails,floors or#he curb stop box and service line. In understand i am also required
to obtain a permit prior to arry work,if necessary.
FINAL NIETER READING(old meter) � �� � � ��
Name: '�"" Y�" Addre� `� t� ��� �"�.
Phone Number�'J"—cJ�v� "v��' Date "���L ' 1
Signature --��� Witness Signature
OLD METER# ��J�G b��
OLD READtNG �� t`"�� fn/
tYEW METER# �� r � 1��'��
NEW READtNG O
E�# ���`��► 3 �� .
FRIDLEY CiTY CODE
CHAPTER 402.WATER,ST�3RM WATER AND SANITAttY SEWER
ADMINISTRATION
(Ref Ord No 113,454,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line conneding the eKisting municipa!system and asry house or buifding fv�whid�the
application is made,the owner or contractor shall be reguired to obtain a permit for such wnnection,and shaU pay a permit fee as provided irr
Chapter 11 of this Code. After sucfi connection has been made,the Water and Sewer Department shall be notified. it shall be uatawful to cover
any connecting tine until an inspection has been made and such tonnection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AMD MAINTEfIiANCE TO CONNECiION
After the initial connection has been made to the water serv'sce curb stop box or the sewer lead at the property line or a water service lead has
bee�e�ctended to the property line for connection,the appiicarrt,owner,or occupant or user of such premises sFiati be liabie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to tfie premis�s. ff the property owner
requests mairrtenance service or repairs be perFosmed by the City,the property owner shatl be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarit,
owner,occupam or user to perform standard maintenance of the sewer seroice tine from the prem+ses to the main inciuding debris dearing or
root tutting and to maintain the water service curb stop boK for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. {Ref 638,1156,1191)
F �g �P ��� �'� 5 �.
n.,•. � r�..„;. ��, �„'.,' + .
��,4+€, rf' r u:.
� �r: "�a:
�Sffi� �� , ;-:y_
�—,..
Date � �'� �7`G /
Old Meter Number �?��Ll� ��
��
Old Meter Reading �-!C� ��
Replacement No. ��l3...�4��� �_
Replacement Reading /� _
Replacement Make � �'e���
Remarks- � tG r��_
t
S igned �^ �`�