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Meter Swap ' Request Number: 16108 Public works Division Service Request Probl em Address: 650 Ely St Requested By: -Mary Erickson Departmeat: WA1ER Address: No address provided ProblemlIssue: INSTALL AMR METER Phone Number: 763-?86-4228 Scheduled Date: 2017-0 -27 �� Sc6ednled 11me: 10:30:00 � � �� ACTION NEIDED: Created by: Wendy Hiatt Date Created: 2017-06-22 AC1IbN TAI�N: � --�Y l.J � (,i� � ................_�...__�_........_. .._.........._-___._ ��.' _ " _. .._._._.._._.._._._._.__-__ Submitter Haa Been `b� Status: In Progress Contacted r Date Completed: r+�� 1 �` �� Completed by: S��4.p lTt� OC, C-' ,., 3�� "��b�° "� � s City of Fridiey s� �� . Water Departrnent 6431 University Avenue PIE Fridley,MN 55432 763-572-3566 1/we hereby authorize the City of Fridiey and/or its employees to do what is neces.sary to replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City 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 or the curb stop box and service line. In understand I am also required to obtain a permit p�ior to any work,if necessary. FiNAI METER READNyG(old meter) _ ��3 t.lL eG� Name:�� l��(�1'�vC?V� Address `-�'�� t �d— ' Phone Number `t� �/' �c�Y �2�Date � ~ � / � i � �Signature _ �(, V6��—��'�� Witness5ignature �_ OLD METER# �� `7 J�� / � OLD READING �� NEW METER# ��a�2 �� , NEW READING D ERT# � � CJ r V! �.�1"' FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADM�NiSTRATION (Ref Ord No 113,454,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to construding or repair of any water of sewer(ine connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shali be required to obtain a permit for such connection,and shatl pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shail be notified. It shail be uniawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the�ty as a proper and suitable connection. 402.06 REPAIRS APID MAINTENAtVCE TO CONNECTiON After the initial connection has been made to the water service curb stop lsox or the sewer lead at tfie property fine or a water service lead has been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shait be liable for atl 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 cequests maintenance service or repairs be performed by the City,the property owner shall be charged for the�of the mai�enance and/or repairs,inciuding necessary street repairs at a rate set annually by an administrative poficy. ft shali be the responsibility of the applicarit, owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premises to the main inctudieg debris clearing 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 the finished grade of the land or property. (Ref 638,1156,1191) City of Fridley �� Water Deparhnent (p��'�v�� Address �.5 � ►-' l � � Name Q �r'L�S d✓� Date g '' r�-ZS�'�� Old Meter Number ! d�� 1 � � Old Meter Reading � � � a` � Replacement No. �6� � L �� /� 1 -- ��''� Replacement Reading S�� o�,a`�'� �2f' '��T��1 Replacement Make �fi.�G[ Wu'' �� ERT# ; � �� .., — '-" i'" . � ,��•�'F Replacemen�El�,'�"#� Remarks: �i� I e� �1 _ Signed�-�^-•--✓,�'�//� � i