Meter Swap A
.. Request Number: 15812
Public works Division
Service Request
Problem Address: 526 Glencoe St Requested By: Tom Leonard
Department: WATER Address: No address provided
ProblemfIsaue: INSTALL AMR METER Phone Number: 763-786-9313
Scdeduled Date: 2017-06-08 Schednied 1lme: 11:OO:OQ
1 a.,�..
ACITON NEEDED:
Created by: Beth Kom�rick Date Created: 2017-06-06
ACITON TAI�N:
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Status: In Progress Sabmitter Has Been r,
Contncted
Date Completed: �, („2 ,,,, `� Completed by: � ��
V l�
�oiy�s��a^edley �V / �' 'J�Q�gD 'Q�
Wa�e�-�e�a�rtrnen�
. � 6431 t�niarersity Avrenue NE S Q � (�(�
Fridley,MN 55432 ` —C �
763-572-3566
iJave hereby authorize the C'rty afi Frid(ey and/or its empioyees to da what is necessary to
re�lace fihe water meter. 1 understand that the pro�oerty owner is Biabte for the water line from the main to the premise and al{irrtereor
plurnbi�g. {Per City code 802.06j 1 also hold tfee Gty of Fridiey and/'rts employees harmiess for any damages that may ocaar while doing this
operation. This to include,but not Iirreited to valves,piping,walts,floors or the curt�stop box and service line. In understand i am aiso requirE
to abtain a permit prior#o any�vark,if netessary.
FINA!METER READING(otd meter) � � `� �� ��
Alame- ��� �� ���G1,1�` V Address ��`�/ �`� l�e.c1 c.c�e �--
Phone9Yumbec G� "' f ��/r 1 3( Date �D '� ZJ — `� —
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Signature Witness Signature
OLD METER# � a �t� ���o
OLD READlNG __ V� �����
NEW METER# _ `��� � O � �
NE1A�'READlM9G �
��-# �1a3 � � � 30
FRIDLEY CtTY CODE
CHAPTER 402.WATER,5`�'QRM WATER AND SANITARY SEWER
ADMINISTRAT1pt1t '
(ttef Ord Na 113,464,565,566,629,638,662,97Z,988,1144,1156,i191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line cannecting the existsng municipaf system and any house or buitding for which t�he
application is made,the owner or coatrador shaH be required to obtain a permit for such connectian,and shall pay a permit fee as prov�ded in
Chapter 12 of this Code. After sucfi connection has been made,the Water and Sewer Departmecrt shalt be notfied. It shaii be unlavirful to,cover
any cannecting line untif an inspection has been cnade and sucfi connection a�d the worlc intident tfiereto has been approved by the C'rty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTEP{ANCE Tp COPiNECTIQN
After the i�itial connection has been made to the waCer service curb stop hoK or the sewer lead at the property tine or a water sesvice dead has
heen exteruied Lo the property line for coanection,tfie appiicarrt,owner,sr occupant ar user of such prem'ises shaU be IYabie frn afl repairs
required to any wafier line and sewer tines necessary for connection of the premises from the main to the premises. ff the property onvner
requests mairrtenance service or repairs be perFormed by the City,the properiy owner shali be charged for the c�ts of the maiM;enance andjor
repairs,inctuding necessary street repairs at a rate set annual{y by an administrative po{icy. ft shafl be the resEtonsibitity oFthe applicar�t,
ovorrter,occupant or user to perForm standard mairttenance of the sewer senr�ce line from the premises to the main including debris dearing o�
root cutting and�o rna7►rtain the water service curb stop box for aperability and at such height as w�t4 ensure that it remains above the finished
grade of the land or property. (Ref 638,1I56,1191)
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city of Frialey
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Water Deoartment
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. Address � �`'b ���l, C r� � _
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Name � r,,, ,�P�1� c�, Y��
Date �-- ' 9 " d ..�� _
Old Meter Number / T� � ��J
O7.d Meter Reading
3 i�.�'d � a � __
, Replacement No. � �-- < ��J (,� � ,
Replacement Reading d
�� Replacement Make ��. �r..�,�.
. , Remarks: d 1 c� 'y{.,��C.,y ;
Signed � _
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