Meter Swap > Request Number: 16616
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Public Works Division
Service Request
Probtem Address: 433 79th Way Requested By: Connie Hefiy
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Numinr: 612-219-3243
Scheduled Date: 2017-08 9 Scheduled 1lme: 10:30:00
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ACTIQN NLEDED:
Created by: Wendy Hiatt Date Cteated: 2017-08-08
ACIION TAI�EN:
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Status: In Progress �bmitter Has Been r
Contacted
Date Completed: �` ` � Completed by:�a �Cn
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�i����radleg� �� / �����'/ � /
illla#���e�a�tm�aat S(�, �,S Z�-J
+ C43�.Unav�rsBty Avenue NE
. Fradl�y,MN 55432
7fx3-572-3566
�Iwe hereby authorize the City of Fridfey andlor its empfoyees to do what is necessary to
re�lace the water met�r. d understand that the property owner is liable for the water line from the main to the premise and all�nte�ior
plurnbing. (Per�Ci#y code 40Z.06J B etso hoid tf�e C"rty of Fridley and/its emp(oyees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In undersfiand i am also require
to abtain a permit praor to any war(c,if necessary.
FINAL METER READtAiG(oid meterj �� ` 1
Name: 1'L Y),o� Address �.� � / L h' ���j
Phone lvumber�!l �� ^�� � �3 p� �`— � -- � �
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Signature Witness Signature �_
O�D METER# � b � C5� U�
OCD READ�AiG v ��� � J�
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NEW READING V
ERT# � ��� ��Y-� 1
FRIDLEY ClTY CODE
CF9APTER 402.WA1'ER,STORM WATER AND SANITARY SEWER
ADMtRflSTRAT{ON
�t�ef Ord No 113,464,565,566,629,638,662,922,988,i144,1156,1191�
4Q2.5 P�RMtT FEE
� Priar to co�structing ar repair o�f any water of sewer line connecting the existing municipal system and any house or buitding for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Wafier and Sewer Departmerrt shall be notified. It shall be unlaw(vl to cover
any connecting line untii an inspection has been made and such connection and the work incident thereto has been apperoved by the City as a
proper and suitabie connection.
402.Q6 ItEPA1RS AfYD MAINTENAiYCE TO COiViVECT10P1
After the initial connection has been made to the water service curb stop box or the sewer tead at the property line or a w�#er service iead has
been extended to the prvperty line for connection,the applicarrt,owner,ar occupant or user of such premises shall be liable for all repairs
required to any�araiter line and sewer{ines necessary for connection of the premises from the main to the premises. tf the}�roperty otivner
requests mairrtenance service or repairs be performed by the Crty,the property owrter shall be charged for the costs of the mairttenance and/ar
repairs,including necessary street repairs at a rate set annualty by an administrative policy. 1t shal!be the responsibility oF the applicant,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to fihe main inctudtng debris ciearing or
roo#c�tting and Lo mair►tain the water service curb sto�box for opera6ility and at sucf�height as will ensure that it remairts above the finished
grade af the land or property. (Ref 638,1156,1191)
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City of Fridley
Water Det�artment
Address l�� �T�����
Name �Psl Ra �I�G�L1 E -
Date ��Q" lQ�
Old Meter Number C �� II(�
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Old Meter Reading I � ��
Replacement No. � ����q
Replacement Reading �
Replacement Make ���
Remarks: 'j"��QQ��'(� �,�,'�{�
Signed
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