Meter Swap = Request Number: 12864
Public works Division
Service Request
Problem�ddress: 7627 Bacon Dr Requested By: Ray Haym�
Dep�rtmeut: WA1ER Addresa: No address provided
Problem/Jsaue: INSTALL AMIt METER Phone Number: 763-780-4790
Sc�edale . 2017-01-27 � Schedaled 11me: 02:00:00
, � �
1.-}:
ACTTON NEEDED: `
Created hy: Wendy HiRtt Drte Created: 2017-01-13
ACTION TAI�N:
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sts�: In Progress suMa�itter xas seon r
Coatute�
Date Compteted: Complcted by:
Ho�s �_�,..1� �� ��,�
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Ln-��r s�r�aoey
Water�epartment 1 n� _ L i �2 Q S?��.� �
6431 i�niversity Avereue P1E �JL' -7 / / C/' �
' Fridfey,MN 55432 �� � � � �
• 753-572-3566 ;
�/We hereby authorize the City af Fr�dley and/or its employees to s!o what is necessary to
repface the water meter. 1 understand that the property owner is liable for the water line#rom the main to the premise and all iMerior
plumbing. {Per City code 402.U5) i aiso hold the City of Fridley andJits employees harmless for any damages that may otcur while daing this
operation. Tfiis to inciude,bufi not limited to ualves,piping,walis,flaors or the turb stop boz and serv+ce line. In understa�d 1 am also required
to obtain a permit prior ta�ny work,if necessary.
FINAL RAETER READING(ofd meterj C/"'��� L�`�
Name: N"''7 r `��`�� Acfdress ��2�� � 4.C�'ti'`�.
Phone Numbe��ll�� ` L tJ"���-wpate �� �� �"��
Signature Mlitness 5ignature
OLD METER# �v���CJ 1��/
Ol.D READtA1G ��� '^�' � �
NEW METER# _ " � V LQ��✓ /
NEW READiNG � ,,�
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�RIDLfY CITY CODE
CHAPTER 402.WATER,STORM WATER ANO SANITARY SEWER
ADMINIS'i'RATION
(Ref Ord No 113.464,565,566,529,638,662,922,988,1144,i156,1191)
402.5 PERMIT FEE
Prior to constructing or repair aF any water of sewer tine connecting the existing rriunicipat system and arry house or buitding for wfiich the
applicatio�is made,fihe owner or co�ractor shatf be required to obtain a permit for such c�nnection,and shali pay a permit fee as provided in
Chapter 11 ofi th+s Code. After such connection has been made,the Water and Sewer Department shall be notified. it shall be unlawFul to cover
any wnrtecting line unti)an inspection has been made and suth connection and the woric inciderrt thereto has been approred by the C'rty as a
proper and witabte connection.
402.06 REPAIRS AND MAfNTENANCE TO CONNECTfON
After the initiat connection has been made to the waGer senrice curb stop box or the sewer lead at the propert�r line o�a water senrice lead has
been extended to the property tine for connection,tfie appiicarrt,ow�er,or occupa�or user aF such premises shatt 6e i'iabk t'or all repairs
required fio any water line and sewer lines necessary for connedion af#he premises fmm the main to the premises. If the properCy owner
requests maietenance service or repairs be performed by the City,the property owner shali be charged for the tosts of the mair+tenance andjor
repairs,inciud'+ng necessary street repairs at a rate set annuaily by an administrative poficy. it shalt be the respons'bility of the applirarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises ta the main inctud�ng debris dearing or
root cutting and to maintain the wrater service curb stop box for operabil�ty and at such heiglrt as will ensure that it remaira aiwve the finished
grade of tfie land ar property. (Ref 638,1156,1191)