Meter Swap ,
; Request Number: 15864
Public Works Division
Service Request
Problem Address: 7818 Alden Way Requested By: Schurr
Departme�: WATER Address: No a�ress p�ovi�d
Problem/Issue: INSTALL AMR METER Phone Number: 763-300-0400
Scheduled Date: 2017-06-20 Sc6edeled Tlme: 11:30:00
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ACTTON NEEDED:
Created by: Beth Kondrick Date Created: 2017-06-0'7
ACITON TAKEN:
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Status: In Progress Submitter Has Been r
Contacted
Dxte Completed: Completed by:
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City o��'rodley �� ��' ���!S�V ���
+ llFlater De�artert�rtt
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` b431 University Avenue NE �� 1J ��� �
F�ailey,MN 55432 ��
� - 7fi3-572-355�
I/we �� � - hereby authorize the Crty of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. I understand that the property owner is Iiable for the water line from the main to the premise and all irtterior
plumbing. (Per�ty�ode 402.06) B also hold the City of Fridiey a�d/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to va(ves,piping,walls,floors or the curb sfiop box and service line. In understand t am also requirE
to abtain a permit prior fio arry work,if necessary.
FINAL METER REAQtNG(old metery ���ZZ�
Plame: Address [ �1��6
Phone lYumber p�
Signature Witness Signature
OLD METER# ""�'—� ��j Cj' �6��
OLD READtNG_ ��Qj2Z:�
_ _ --�- ___ --- -
ME���R# II IIIIIIIII IIIIII��lII!lIII�I
� 4922fi088
NEW READlNG � __ _ _
E�-#� IIIIIIIIIIIIIIIIIIIIII E
'I 'I 72227388
FRIDtEY Gf'iY CODE
CHAPTER 402.WA7'ER,STORM WATER AND SANITARY SEWER
ADMINtSTRATION �
(�tef Ord No 113,Q�64,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer iine connecting the existing municipal system and aey house or building for which tfie
application is made,the owner or corrtractor shall�te required to obtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be rto't�'ied. It shall be untawful to cover
any connecting line until an inspection has been made and such connection and the work inadent thereto has been approved by the City as a
proper and suitable wnnection.
402A6 REPAIRS AIUD MAINTENANCE TO COPIPIECT{ON
After the inifiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property dine for sonnecfiion,the applicant,owner,or occupar�t a�user of such premises shali be liable For ail repairs
required to any water dine and sewer tines necessary for connection of the premises from the main to the premises. If the groperty owner
requests mairrtenance senrice or repairs be performed 6y the City,the property owner shali be charged for the costs of the mainttnance and/ar
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the appitcarrt,
owner,occupant or user to perform standard mairrtenance of the sewer senrice line from the premises to the main induding debris dearing 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
.
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`7 C�/
City of Fridley
�, Aater Deaartment
. Address ���$ ,�!���.t"f'� (.c�cr� _
Name__�r'ci c��c T- �G r? v�''s�. , . _:
Date ,�CC>l�°"�� - '
Old Meter Number � 2 �'"C �
Old Meter Reading
' Replacement No. ,
" Replacement Reading_ c'9c�CC� ,
� Replacement Make__L1'� " '� '�� '
.,. Remarks: � �
Signed
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