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Meter Swap r � . Request Number: 15433 "�' T Pub1iC WOrks DivislOri Service Request Problem Address: 122 Craig Way Requested By: Colleen Department: WATER Address: No address provided Problem/jssae: INSTALL AMR METER Phone Number: 163-742-7583 Sc6eduled te• 2017-OS-24 5chednlcd T1me: 04:00:00 � �� UY"1 ACTTON NEEDED: Created by: Beth Komirick lhte Cre�ted: 2017-OS-18 ACTION TAI�N: .s ......:�tn-�:�.-�CC� __.__._ ��___._ `.. _________ � ______._. ..._...._...�._..___�..__._______.�_...._._....__......_.__..._..._...�..�..._�:,, _ ��_ Status: In Progress Submitter Iias Beee �... Co�rtacted Date Com leted: Com eted p �� .� � �: �� / •/ ��V KiV yV� .. �t% t� V�� City of Fridiey � Water Department � � � [�� -��. 6431 University Avenue NE Fridley, MN 55432 763-572-3566 ��We hereby authorize the City of Fridley and/or its employees to do what is neaessary to replace the water meter. f understand that the property owner is liable for the water line from the main to the premise and all tnterior plumbing. {Per Gry code 402.06) i aiso hold the City of Fridley andjits employees harmless for arry damages that may ocwr whife doing this operation. Thls to include.but not limited to valves,piping,walls,floors or the curb stop box and service line. In understancl i am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) � �a3�� a Name: �� l�Q� Address---��fh ( (,�! �,�J�� Phone Number �� ^ ` L��g 3 Date J� o��`"r�� Signature Witness Signature `� OLD METER# �J� `v �v � OLD READING �� ! �V� NEW METER# t�lo'�p�.�Q OO� NEW READING V ERT# _ �� FR{DLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,b62,922,988,I144,115b,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer iine connecting the existing municipal system and any house or Iwiiding for which the appiication is made,the owner or contractor shali be required to obtain a permit for such cennection,ant!shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departme�t shall be notified. it shall be unlawful to cove� any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitahle connedion. �402.06 REPAIRS AND MAINTEIY,4NCE TO COPINECTION After the initial connection has been made to the water serv(ce curb stop box or the sewer iead at the property line or a water service fead has been extended to the property line for connection,the appiicant,owner,or occupant er user of such premises shall be liabte for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner requests maiatenance service or repairs be performed by the City,the property owner shali be charged for the costs ofi the maintenance and/or repairs,including necessary street repairs at a rate set annuaily by an administrative pnliry. it shal{be the responsibility of the appliqrrt, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main inciuding debris dearing or root cutting and to maintain the water senrice curb stop box for operability and at such height as will ensure that it remains above tfie finishec! grade of the land or property. (Ref 638,1156,1191j � �3�� V f 5--�'!`!?S_" _ V ��g�J City of Fridley Water De�artment Address � ��C �� - Name �LL.�.� ��l I �'��1 �-� �ate � L1—�. Old Meter Number � � �� l Old Meter Reading � J �� Replacement No. �S�� Replacement Reading� Replacement Make �5��'{Z- Remarks: �L�/�.-.�AAL� /v1�T� Signed � ��: �' i REQUEST FOR SERVICE REPORT CITY OF FRIDLEY Reference No. �� J� Date: � l \ — � � � Request Type: ��l�}� �� Entered By: Department: Citizen Name: ��L�j � NC. Address: �aa ��C (,�,�� Phone Number: ' � ` 7 ��37a 5�� Scheduled Date: Property Owner: Location Details: Request Details: Action Taken: c -� �� 31� � � �� t t� �-� � � �� s � � I��. �� c�P, S�- �u ��c� ��- ��-Um� r� ��-�ti�- ��P�� Responsibl_e Person: Approver: Completion Date: ��_ � Citizen Notified: � �