Meter Swap �
t ` Request Number: 12988
Public works Division
Service Request
ProWem A�ddress: 7665 Bacon Dr Requested By: Tamara Carlson
DepartmeM: Vi7ATER Address: No address p�ovicied
Problem/tssue: INSTALL AMR METER Phone Number: 612-242-9780
Schednled Date: 2017-01-24 5c�eduled T[me: 02:00:00
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ACIION NEEDED:
Created by: We�ty Hiatt Date Created: 2U 17-01-20
ACIION TAI�N:
I �. � I� 1� M �.
Statua: In Progress Snbmitter Has�een r,
Contuted
Dste Completed: Completed by:
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�a�-
�tVate��e�artrnerat
6431 iJnivea-sity Avenue 6Y� -��� - y 9 g �'70 -- � 5
Fridley,MN 55432
y 763-572-3566 � � � ' � 3
�,�!`e her�by authorize the Ciiy af Fridley andjor its empioyees to do wfiat is necessary to
replace the avater rneter. �understand that the properry owner is tiabte for the water line from the main to the premise and a11 interior
plumbing. (Per C'rty code 402.06) i also hold the�ty of Pridley and/'rts employees harmless#or ar�y damages tFiat may occur while doing tfiis
o�aer,ation. This to include,but not limi#ed to valves,piping,walls,floors or the curb stop box and service tine. In understand!am also require�
to otrtain a perm'rt prior to any woric,if necessary.
FINAL M READING(oid meter) �� L�t.� ��
Name: `w V v�. �
Y i dress _(1��� ���1 � �
Phone Number��� ������{� p� 1���—l `
Signature �- W�tness Signature
vio nnEr�R# � 52�. � 1 �y
OLD READtNG _� � Z 7 �S�
NEW METER# "-C� � ��j� 1�
NEW READNVG �
ERT# �.�!/� �✓��$ .
FRIOLEY CITY CODE
CHAP'TER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISi'RATION
(Ref Ord Ho 113,464,555,566,529,fi38,662,922,988,I144,1156,1191j
442.5 PERMIT FEE
Prior to constructing or repair of ar�y water of sewes line connecting the existing muniapaf system and arry house or building for which the
application is made,the owner or currtractor sha(f be required to obtain a permit for such wnnedion,and shall pay a permit fee as provided in�
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be not'rf"ied. It shall be untawfut to cover
any cannecting{ine uritif an inspection has been made and such connection and the wo�c inciderrt thereto has been aqproved by the City as a
proper and su'rtabie connection.
402.06 REPAIRS AND MAIPITEfVANCE TO CONNECTION
After the initial connect'svn fias been made to the water service curb stop box or the sewer lead at the property line or a water seraice lead has
been extended to the property line fior connection,the applicarrt,owner,or accupant or user of wch pr+emises shai!be tiable for al{repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. �f the property owner
requests mairrtenance service or repairs be perFormed bq the C'ity,the property owner shail be charged for the costs of the mairttenance and/or
repairs,includin�necessary street repairs at a rate set an�uaily by an administrative potiry. ft shall be the responsibility ot'the applicarrt,
owner,occupan#or user to perform standard mairrtenance ofi#he sewer service fine fram the premises to the main including debris dearing or
root cutting and ta mairrtain the water service curb stop box for operability and at such height as wili ensure that�t rernains above the fintshed
grade of the land or property. (Ref 638,1156,1191)
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City of Fridley ��� ��1
water De»artment �l°/�'���
Address ���� �G-ca"� �"
Name .ev, �.r�Sa�. —
Date l 3"_ '''l t� "� G �
Old Meter Number 1 �" ��`S�j
old Meter Reading ��b � �� G
Fteplacement No. �"� � � '
Replacement Reading �
Replacement Make �'``� `-� '
Remarks: �reZU-.. !'I^.�.�'�.✓�
Signed
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