Meter Swap ' Request Number: 15802
Public Works Division
Service Request
Problem Address: 548 Fairmont St Requested By: Deborah Langer
Department: WA1ER Address: No acWress provided
Problem/Issue: INSTALL AMR ME1�R Pho�Number: 763-�83-0645
Schedaled Date: 2017-06-09 Seheduled 1lme: 10:30:00
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ACTIOAi NEEDED:
Created by: Wendy Hi�t Dwte Created: 2017-06-06
ACTION TAKEN: �` . `�n�;_ ,- �9
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Snbmitter Has Been �
Status: In Progress Contacted r
Date Com�eted: � .- l� Completed by: � � �,����� `
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, �6ty o��r�dley �O� _ f���Q�v r-Q �
Water�e�airtnaeo�t `�
t 6431 t.lni��rsBtyAerersue NE ��. ��as
Fa�dl�ey,N6N 55432
763-572-3556
!/we hereby authorize the Crty of Pridiey andJor its employees to tlo what is necessary ta
replace che water meter. !understand that the property owner is liabte for the water line from fihe main to the prernise and ali irrterior
plumhi�g. (Per£i#y code 402.06) 1 aiso hold the City of Fridtey and/its employees harmless for arry damages that�nay occur while doin�#his
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and senrice line. In understand 1 am afso requir�
to ohtain a permit prior to any work,if necessary.
FINAL METER READiPtG(old meter)—___ _1 — i g �� �
Name: �/�YJ D�G.� �.1.G1-PA�''r Address J�V ��C���- �V�.� �� -
Phone Number�� '��� —��� Date � ' l � � l
Signature ��
Witness Signature
OLD METER# � �Q
OLD READING /��(�� � d
NEW METER# � ��� � � l �
NEW READINC; v ,�
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El�T# � �O'� p� � � � d
FRtDLEY CfTY CODE
CHAt�TER 402.WATER,ST�RM WATER AND SANfTARY SEWER
ADMINISTRA770N �
(Ref Ord NO 113'464�5650 5i66�629�63$�662�922�988�1144�1156,1191'
402.5 PERMC{'FEE
Prior to constructing or repair af any arater af sewer iine connecting the existing municipal system and acry fiause or building for which the
application is made,fihe owner or contractor shall be required to obtain a perrnit for such�nnection,and shati pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall6e not'rfied. {t shall be unlawful to�over
any connecting line until an inspection has been made and such cannection and the work incident thereto has been apprrnred by the City as a
proper and suitable connection.
402.06 REPAtRS ANp 1V(q{NTENq�yCE TO COMAiECTfON
After the initiai connection has been rnade to the water service curb stop box or the sewer lead at the property►ine or a water senrice{ead has
been extended to the property line for wnnection,the applicarrt,owner,or occupar�t ar user of such premises shaf{be liabte for ail repairs
required to arry water line and sewer(ines necessary#or connection af the premises from the main to the premises. tf the property owner
requests mairrtenance service or repairs be performed by the C"tty,the property owner shall be charged for the c�ts o#the maintenance and/or
repairs,inc(uding necessary street repairs at a rate set ennually by an administrative poltry. It shall be the responsi6ility of the applicant,
owner,occupan#or user to perform standard mairrtenance of the sewer senrice line from the premises to the main induding debris dearing or
root�utting and to mairrtain the water service curb sCop box for operability and at such height as will ensure that it remains above the�nished
grade afi the tand or property. (Ref 638,1156,1191)