Meter Swap Request Number: 12520
' Public Works Division
Service Request
Problem Address: 7528 Hayes St Requested By: Julie Ampe
Department: WA'IER Addrea�: No aci�ess provided
ProWem/Iasae: INSTALL AMR METER Phone Number: 763-783-4534
Schedule e: 2016-12-2 �o/ Sched d Time: 08:00:(f0
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AGIION NEEDED:AMIt
Crcated by: We�y Hiatt D�te Cre�ed: 201 b-12-20
ACIION TAKEN:
`�-�15�-c�.�����. ���-
Status: Tn Progress Sebmitter Has Been (..,
Coutacted
Date Completed: Connpleted by:
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Hiatt, Wendy
• Subject: Jufie Ampe 763-783-4534 install new AMR, current meter very low cons, slowing down?
Location: 7528 Hayes St
StaR: Thu 12/22/2016 8:00 AM
End: Thu 1 2/22/201 6 8:30 AM
Show Time As: Tentative
Recurrence: (none)
Meeting 5tatus: Not yet responded
Organizer: Hara, Sandra
Required Attendees: Hiatt,Wendy
1
City of Fridley
Water Department ��j--,�U�7����—
6431 University Avenue NE �
Fridley,MN 55432 � ``1 I � � �
" ' ` 763-572-3566
1 jwe herehy authorize the City of Pridley and/or its empioyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liabfe for the water line from the main to the premise and atl iMeriar
plumbing. (Per C"rty code 402.06) 1 also hold the City of Fridley and/its employees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand I am a{so required
to obtain a permit prior to any work,if necessary.
fiNAl METER READING(old meterj __�� �� { � �
Name:� (1 I1Q� ���Q Address �� ��
16��? �` 3�f T�
Phone Number Date_ �� ~ 2� � � �
�Signature � Witness Signature " l �
OLD METER# � � i � Ci � ��
OLD READING e Z���,� lJ
NEW METER# "l� �1 L�?1 ��
� NEW READING _ ��
ERT# � (JU ��� L� ,
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FRIDLEY CiTY CODE �
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecttng the existing municipa!system as�d acry house or building for which the
appiication is made,the owner or cantractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of tfiis Code. After such connectlon has been made,the Water and Sewer DepaRment shaN be notified. It shali be unfawiui to cover
any connecting line until an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connectton has been made to the water service curb stop box or the sewer lead at the properly iine or a water service lead has
been extended to the property line for connection,the applkant,owner,or occupa�rt or user of such premises sfiall be liable for all repatrs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner sfiall be charged far the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. It shali be the respansibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service{ine from the premises to the main includirig debris dearing or
root cutting ar►d to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
. �� 1 �'y '�Y
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City of Fridley��z�j` ..
Water Departrnent �'������
1
�►,r� � Sv��e � �,�e
�� s� � `7�"a�d 1��.,�s
� Date ��-" d'� �"''� �
Old Meter Number a"��7
r---
Old Meter Reading �S� Q �
Replacement No. �� ` -b ���
Replacement(Reading �
Replacement Make a �r �
ERT# �,D� O ���� �
Replacement ERT#
Remarks: � `i°�"-
Signed��
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