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Meter Swap . . Request Number: 16321 Pu�ic Works Division Service Request Problem Address: 7951 Broad A� Requested By: Jane Lagesse Department: WATER Address: No acl�ess provided Problem/Issue: INSTALL AMR METER Phone Number: 763-784-5471 Schednled Date: ZO1 -07-19 � Scheduled 1lme: 10:00:00 ACTION NEEDED: Crested by: Wendy Hiatt Date Created: 2017-07-13 ACIION TAKEN: S`1�_ �.1..-.`......................._,��--e�..........__..._.......................___._�.._�___.� __._�___�_____._____ _.._...._...... �-..._____ Status: In Progress Sabmitter Has Been �., Co�acted Date Completed: � A �� Completed by: � �� a �� u. ��,�� _�I City o#Fridley , � Water Departr�+ent S � :�f C�..,�Z'�j � 6431 University Avenue NE Fridiey,MPI 55432 7fi3-572-3566 �f`Ne hereby authorize the Gty of Fridley and/or its employees to do what is necessary to replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and ail interior plumbing. (Per City code 402.06) 1 afso hold the City of F�idiey and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,wafls,floors or the curb stop box and service line. in understand 1 am also required to obtain a permit prior to any work,if necessary. FIPIAL METER REAQING(oid meterJ �� Name• �55 e _ Address _ t 1 ✓ 1 �� Phone Number ��0 3" � '� 7�Z 1 p� �''� �� — t� �Signature Witness Signature OLD METER#_�`�-/l1�✓ �� OLD READING__��l.J�.,J NfW METER# J� �� t `U NEW READING V ERT# �� C7^) � FRiDLEY CiTY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,fi38,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any watec o�E sQwer{ine connecting the existing municipal system and any house or building for which the application is made,the owner or cor�trackor 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 Water and Sewer Department shall be notified. It shall be unlawful to mver any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Ctty as a proper and suitable connection. 402.06 REPAIRS AND MAIAITENANCE TO COPINECT40tV After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has been extended to fihe property line far connection,the app{icarrt,owner,or occuparit or user of such premises shall be IPable for all repairs required to any water line and sewer lines necessary for connection af the premises from the main to the premises. tf the property owner requests maintenance servPce or repairs be perFormed by fihe C'rty,the property owner shall be charged for the costs of the mai�rtenance and/or repairs,including necessary street repairs et a rate set annually by an administrative policy. It shall be the responsiErility of the applicant, owner,occupant or user to perform standard mainter►ance of tfie sewer senrice line fram the premises to tbe main including debris clearing or root cutting and to maintain the water service curb stop I�ox for operabifity and at such height as will ensure that it remains above the finished grade of the land or properCy. (Ref 638,1]56,1191) �:� �� :- �l' � ��T' Y �,f�' �.m `e}�iy�.�.: '� ,. .� �� '� .A .-�-.fSi.s:'' '�^'i:) £ � 4 Aa��e�s_ � I �� ,�•r'�- Name_ �*E,rs C S.�-�- � Date �"� �'" '�Q g : Old Meter Number e�� Old Meter Reading �� Replacement No._,�� 5�8 3-- Replacement Reading � Replacement Make ,�,� .._,,... Remarks:_ O Jo� ��'-.y Signed � � ,� � � , � { a � �,��* �.�� '•�da x r;^ k �,,; �.: , i � � „t ' �'' y�<k.sa7r,.. . x ,,, � „ , . , .� r�� r. ., ,� ,<< ... .,," ^� r, ��{x."�$$_ . ��/.-�^'�..�.�� _ Name_ �aE,cr e_�.S•c. ' Date ��"� �'" '�� Old Meter Number .(,�' ,v�9 �� Old Meter Reading 7'� ��-�� Replacement No._,3��}��.5+8�-- Replacement Reading � Replacement Make ,�� .�._..... Remarks:_ O Jo� y�,,.�:.y Signed },_ � �"". � � �