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Meter Swap 4 ti Request Number: 15298 Public Works Division Service Request Problem Aeddress: 7136 East River Rd Requested By: Jan I.ehrke Department: WATER Address: No address p�ovided Problemllssue: INSTALL AMR METER Phone Numbcr: 763-574-0031 5e�edWed Ds►te: 2017-OS-16 5c6ednled 1lme: 01:00:00 � � r ACITON NEEDED: Created by: Beth Ifox�rick Datc Created: 201?-QS-11 AC7ION TAI�N: .-�-----.......__._.__... .....� ��..._�.��e.�..._ ��R-.-- _ Status: In Progress Sabmitter Has Been �.. Co�acted � D�te Compieted: � fi � �.� Completed by � .,... �I.p �,� `Q �, � . ,::X�:�:. � - a�i�'..w.. '`' . � . � �� l� -�r City of Fridiey WaterDepartrnent � h� �� 6431 University Avenue NE tJ Fridley,MN 55432 763-572-3566 �JWe fiereby authorize the City of Fridley and/or its employees to do what is nesessary to replace the water meter. i understand that tbe property owner is liable for the water line from the main to the premise anci ali irrterior piumbing. (Per City code 402.06) 1 also hold the Gty of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walis,floors ar the wr6 stop box and service line. In understand 1 am aiso required to obtain a permit p�ior to any work,if necessary. FlNAL METER READIN6(old meter) " ��q �� Name:� � Ue h r l��e �,dreu ! 1.J ll� ��i�' ��l�Y' �. Phone Number ` �"�— �7�y ��J f Date �l`� �� Signature Witness Signature OLD METER# V" f � �b� OlD READING �'�'`� ` �� NEW METER# � �o�1 � ` �d� NEW READING � ERT# � ` �� O�- FRIDLEY CITY CODE CHAPTER 4d2.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATfON (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMtT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipai system and aoy house or building for which the application is made,the owner or contractor shaN be required to obtain a permit for such connection,and shail pay a permit fee as provided in Chapter 31 aF this Code. After such connection has been made,the Water and Sewer Departmerit shali be notified. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the worlc incident thereto has been approved by the City as a proper and witab{e connection. 402.06 REPA{RS AfYD MAtNTENANCE TO tONNECTION 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 the property line for connection,the applicant,ownec,or oczupant or user of wch premises shail be liable for all repairs required to any water line and sewer lines necessary for connection af the premises from the main to the premises. ff the property owner requests mairrtenance service or repairs be perFormed by the Ciry,the properly owner shall be charged for the�of the mairrtenance and/o� repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibiltiy of the applicant, owner,occupant or user to perform standa�d mair�tenance of the sewer service line from the premises to tfie main induding debris dearing or root cutting and to maintain the water service curb stop box for operabif'�ty and at such height as will ensure that it remains above the Rnished grade of the land or property. (Ref 638,1156,1191) _ � �.-�;:��.:..,.�, ._ .. � , ��.,� _ _._ �� V �/�f� ��:� City of Fridley Water Denartment Address_ � � �� . �� Name_ ,J u�t� � `� � G�� . Date ,��' `� Old Meter Number �� g�j s Q '� Old Meter Reading �� G �3 Replacement No._��p �� l � ��j� Replacement Reading �j Replacement Make � P� Remarks: p�� `��-,�f�.-�"�� .� �� S igned - �z----- ,� G , �•.