Meter Swap Request Number: 15971
� Public works Division
Seivice Request
Problem Address: 594 Glencoe St Requested By: Dan McKee
Department: WA'IER Address: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-644-1765
Scheduled Dnte: 2017-06-19 Sc6ednled 1lme: 08:00:00
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ACIION NEEDED:
Created by: Wendy Hiatt Date Cre�ted: 2017-06-13
ACIION TAI�N:
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Status: In Progress 5nbmitter Hxs Been �..,
Contacted
Date Completed: Completed by:
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�611y o�f�ridley ��� � �D�10�/ �
Water�epartea��n�
, t431 llnioeersity Averaue 1VE Q�
, �r6clley,N!N 55432
763-572-3566 s�� ��2�
��°Ne hereby authonze the Crry of Fridley and/or its employees to do wfiat is necessary to
repface the water meter. 1 understand that the property owner is liable for the water line from the main to ihe premise and all iirterios
plurnbing. (Pes�ity code�02.06) 1 alsa hold the C'rty of Fridley and�ts employees harmless for any dama�es that rnay oc�wr while doing this
operation. This to indude,but not timited to vafves,pipin�walls,floors or the curb stop box and service line. In understand 1 am aiso requirE
to abtain a permit prior to any work,if oecessary,
FINAL METER READIAIG(ofd meterj v�� I��
Plame: �Q� 1�`G v�"� Address_ �� <Sti�le--�C�� �
Phone 9Yumber �Ii��Q�� 1,r� �j Date� r �r���
5ign re � Witness Signature
OLD METER# ��0� ����
OLD READtNG O ^�J � v�O
NEW METER# _"I,��`(d r1iV �`�'
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NEW READING i_ )
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El�T#� 4 � � �� � 1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORNI WATER AND SAMlTARY SEWER
ADMlNlSTRATtON
(ltef Ord No 113,464,565,566,629,638,652,922,9$S,5144,1156,1191y
402.5 PERMIT FEE
Prior to aonstructing or repair of any water of sewer line connecting the existing municipa4 system and arry house or fwifding for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such�nneetion,and shai!pay a perrnit fee as provided in
�hapter il of�his Code. After such connection has been made,the Water and Sewer Departmerrt sf�all be notified. It shall be unlawfu{to cover
any connecCing line urrtil an inspection has been made and such connection and the work incident thereto has been approved by ihe City as a
Qroper and witable connection.
d02.06 REPAIRS AND MAINTENANCE TO COPIIVECTiOM
After the initiai connection has been made to the water senrice wrb stop box or the sewer(ead at the property tine or a water senrice lead has
been extended to the property line for r,onnection,the applicarrt,owner,or occupar�t or user vE such premises shall be 13able for all repairs
required to any water line and sewer lines necessary for conneetion of the premises from the main to the premises. tF the property avner
requests mairrtenance senrice or repairs be perfoRned by the City,fihe property owner shaii be charged for the c�ts of the mai�tenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. ft shall be the responsibility of#he applica�,
owner,occupaat or user to perform standard mair�tenance of the sewer service Iine from the premises to the main including debris dearing or
root cutting end to mai�ain the water service curb stop box for operability and at such hei�hht as will ensure that it remains above the finished
grade a�F the land or property. (Ref 638,1155,1191)
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� C�.ty of Fridle�►
�ater Departmen�
Address � l�l"� �')t���C��7
Name !f 1�1� 1 Q��Ck�
Date �'�l -v�
Old Meter Number ��`, �
Old Meter Readin 1 "'L
Replacement No. ��
Replacement Reading
Replacement Make �'j� �C''� _
Remarks: �"'j L1� /'���'C'�, -
S igned �����..�„� ?,�a�