Meter Swap �
, Request Number: 15666
Public works Division
Service Request
Problem Address: 8102 Fairmont Circle Requested By: Deborah
Department: WA'IER Address: No address providcd
ProblemRsaue: IN5TALL AMR METER Phose Nnmber. 763-639-1923
Sehe�led Date: 2017-06-OS� Sehedaled Time: ` 07:OO:OU
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ACIIQN NF.F,DED:
Created by: We�y Hiatt Dwte Created: 2017-Og-31
AG7iON TAI�N:
.�..�V� S�.I�
Status: In Progress �nbmitter Has Been �.,
Co�acted
Date Completed: Completed by:
� � �^ �7 ,S�.k�e
�i�y���dtey 'J
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Water Departr�en� CC/ TT `�'� _` ` �
S 6rt31 l�niorersity A�enue NE �,
� Fridleya MN 55432
763-512-3566
1/we hereby authorize the City of Fridley andjor its employees to do wfiat is necessary to
replace the water meter. t understand that the property owner is liable for the water line from#he main to xhe premise and alf irrterior
plumbing. (Per City code�Q2A6J 1 also hofd tt�e Cety of Fridley andrts emp{oyees fiarmEess for arry damages that snay occur white doing this
operation. This to inciude,but nat limited to vaives,piping,�eiralls,floors or the rurb stop box and senrice line. In understand!am aiso requirE
to abtain a permit prio�to any work,if necessary.
FiNAL METER READitiVG{old meterj � � f �� � `�
Name• ��..° b b 1�U..� Address � i U� �� f 1N10✓�T" '(�t�V�.��
Phone Number ��E �— �j�— (-1 o� -1 Date �— � '— ! �
Signature Witness Signature `�
OI.D METER# _ ��3�� ��
OLD READtNG � �3 � U
NEW M€TER# __ 1��c� ��a�
NEW READlNG �
ERT# ����, / ► lVo�
FRtDIEY C1Tl CODE
CHAPTER 402.WATER,SCC?RM WATER AND SANITARY SEWER
ADM6N6STRATION �
{Ref Ord No 113,4fi�,565,566,629,638,662,922,988,i144,1156,1191j
AOZ.S PERMiT FEE
Prior to constructing or repair of any water of sewer line connecting#he exisCing municipa!system and any hause or buiiding for which the
application is made,the awnet or corttractor shait be required to abtain a permit for swch connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shali be notified It shal!be unlawfuf to cover
any connecting line ur�#i)an inspection has been made and such connection and the work incident fihereto has been approved by#he C�ty as a
proper and suifiable cQnnection.
402.06 REPAlRS APID MAINTEWANCE TO GOMPiECT10N
After the initiat connecfiion has been made to the wa#er servite curb stop hoK ar the sewer iead at the properly fine ar a water servi�(ead fias
been eutended to the property tine for r.onnection,the applicarrt,owner,or occupar�t or user of such premises shall be liabte fior afl repairs
required to any water line and searer lines necessary for connection af the premises from tfie main to the premises. ff the property owner
requests maintenance seneice or repairs be perFormed by the City,the property owner shail be charged for the casts of the maintenance andjor
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility aF the applicar�t,
owner,occupant or user to perform standard rnairrtenance of the sewer senrice line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box far operability and at such height as wiN ensure that it remains above the finished
grade af the tand or property. (Ref 638,1155,1191)
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' � city of Frialey
;; Water Department
. ' Address� � �� ����� 1�'�01'�� C����$ _
.. Name � PC� i�o hden , . _. _
Date �-� �' � -b� _
Old Meter Number �� S ���
Old Meter Reading dJ y d -
' Replacement No. a' 6�U $S �
' Replacement Reading d
" Replacement Make a d ef
, Remarks:5��,� 0� bG�o c l y�Y��2��r
�b'� kld t' �+�-�
. . 4� , ..._...
Signed ! �
__. _ ,.._ _ , _ _ ;. _. _. _ _ _ . ..
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