Meter Swap .
.
Request Number: 16075
Public Works Division
Service Request
Problem Address: 8121 Fairmont Circle Requested By: Kristin Seery
Deputment: WA'IER Address: No address provided
Pt�blem/Issue: INSTALL AMR METER Phoae Number: 763-784-4866
SchedoledDate: 2017-0 -27 Scheduled'lime: 09:00:00
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ACTION NEEDED:
Crexted by: Wendy Hiatt Date Created: 2017-06-21
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ACIION TAI�N:
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Status: In Progress Snbmitter Has Been r
Contscted
Date Completed: (,,,_ ��''f��c.� Completed by: � ��,�
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City of Frid9ey `� �`� _
} Water Departr�ent �� '��
' 6431 t1niversity Avenue NE
Fridley,MN 55432
763-572-356fi
�1'"�e hereby authorize the Gty of Fridley and/or its employees ta do what is necessary ta
replace the water meter. 1 understand that the property aarner is liable for the water line from the main to the premise and a{f imerior
piumbing. {per City code 40Z.06) I also hoid the City of Fridiey and/its empfoyees fia�miess for arry damages that snay auur wfiile doing this
operation. This to include,but not{imited to valves,piping,walls,floors or the curb stop box and senrice line. in u�derstand 1 am also required
to abtain a permit prior to any wark,if necessary.
F1NAl ME'TER READtNG(oid meterj � � � �v v
Name: ��`l'J l�,� s'�°`���/ Address ��`—� �GLf�W�Y1�� �`"`"1�
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Phone Mumber ���J ' r V� '���tQ U/pate ���� � � �
�Signature UV'rtness Signature
OLD METER#_.�v ��U"�
OLD READING — " � ✓ v ��
NEW METER# ` ��� ���
NEW READIAIG v
ERT# ���� � ! �
FRIDLEY C1TY CODE
CHAPTER 402.WATER,STORM WATER AND SAN{TARY SEWER
� ADMiNfSTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,i191)
402.5 PERMIT FEE
Prior to construetin�or repair of arry water of sewer tine connecting the existing municipai sysCem a�d any house ar buitding for which the
appticatio�is made,the owner or contractor shall be required to obtain a permit for such connection,and sha14 pay a perm�t fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shal!be notified. It shal{be unlawfut to cover
any connecting line unti{an inspection has been made a�d such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
40Z.06 REPAIRS APiD MA{P{TENANCE TO CQNNECTION
After the initial connection has been roade to the water senrtce aarb stop box or the sewer lead at the property iine or a water servite tead has
been extended to the property line for connection,the applicar�t,owner,or occuparrt or user of such premises shall be�table for atl repain
required to any water line and sewer lines necessary for con�ectiun of the premises from the main to the premises. If the pe+operty owner
requests maintenance servPce or repairs be performed by the City,the property cswner shaN be charged for the casts of the mairrtenance and/or
repairs,including necessary street repairs at a rate s�et annuaily by an administrative poficy. R shali be the responsibility of the apptica►�t,
owner,occupent ar user to perform standard maintenance of the sewer service line from the premises tv the main including debris clearing or
root cutting and to maintain the water service curb stop box for operabiltty and at sucfi height as will ensure that it remains above the finished
grade of the land o�prop¢rty. (Ref 638,1156,1191)
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�� '� INSTALLATION
V STANDARD WATER METER
C17YOF
FRIDLEY
Address ���� 1—l�<<Z!'��� �2-
Name ���5 ( 1� � ��7�
Date L(�`����
Old M er �—I� J ---_--�--�
�97 '�
Old M ea ing �
Replacement No. `� UC�J��
Replacement Reading �
Replacement Make �f �J�7' L'�
Remarks: ��� �����-'�—
Signed: