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tJ+ave here(�adathorize the�'aty of�P9dfey and/or rts�mployees to�la what�s necessary�s
repfaea the w,ater rne�ter. 9�andersqnd t¢0at ihe�roperty ouvner is 9iable far tPoe rovater line from the inaire to the�resnise and afl irnerior
�duraaising. {Per�y code 4�2.�6� f atsrs hoid the�ty�f Fr�dley andJ'�ts empfoyess harmless for arry da�a�es thaC rrtay ocrur wltile t{oing thi;
��eration. '4'his to�nclude,!mert not limi�eai to valves,piping,�+ratts,#loors or the,curb stop box and senrice line. !n undeesfiand i am atso requi
to abtain�permit praor ta any wortc,if a�etessary.
PfNfOt METER READINfG�oid meterj ��" V I ���✓
Name:�I�.X______�(��'�� Address I (Cj �
P4�one lVumber ` � (�" ���"1�1 pate__ ( )'"'"L 5 ` � 1
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�Signature �`::�-� _,.---- - � �_
�r. --� Witness Sigrtature
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• FR9DLEY CBT(CODE
C4�iA�9'ER 402.1MATE8�,5"9'�RfVt WATER�►ND SANiTARY SEWER
�1�M1t{V!S't'RA7'ION
4ite�Ord N�113,464,565,566,629,538,66Z,922,98$, 1144,1156,1191j
4a2.S PERMiT FEE
� Praar to�onstructing ar repair�f any water of sewer line connecting the existing municipal system and arry house or buiiding#or which the
appticafiion is made,the�nrner ar car�trackor shall be required to obtain a per�rrtit for such cnnnection,and shall pay a permit fee as provided ir
�hapter 11 of this Code. After such connection has�een made,the Water and�ewer Deparimerrt shail be notified. It shai!be unlawful to t�n
an�connecting line u�tit an inspection has been made and such connection and the�rark incident thereta has t�een approved Ery#�e City as a
�roper and suitable sunnection.
402.06 ltEPA1RS Ai�iD 44TABN'�IEPiARICE TtD�ONNEC170N
After the 9nitiai connection�as been snasle fio ti�e water servPce curb stop box or the sewer fead at the property line or a water service tead has
bsen extended to the prapee�ty line for conreection,the appliqrrt,aarrter,or occuparrt or user of such premises shall pe liable for ail repairs
required to any water(ine and se+nrer[ines necessary for cossnection aF the premises from Che rnain to the premises. If the property owner
requests rttairrtenance serv�ce sr repairs be performed by fihe�ty,the property rnwner shall be charged for the costs of the maintenance andJo
re�airs,inctuding necessary street repairs at a rate set annually�•{an admin�strative poiicy. it sfiafi be t�e responsibility of the applirant,
owne�,occupan�t ar user to perform standard mairrtenance of tfie sewre�service line from the premises to ihe main including debris clearing nr
root suteing end to mair�tain the water sero�ce curls sta�o 6ox f�r opera6itity and at such height as wi{{ensure that it remains above fihe finished
grade of the land or propert+/. {Ref 638,1155,1191j
J •
�
Request Number: 16626
� �
.
Public works Division
==� Service Request
Problbm Address: 6922 Hickory Dr Reqnested By: Alex Dalton
' Department: WATER Address: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Nwmber: 1-507-450-1467
Scheduled D�e: 2017-08- � Scheduled'llme: 09:OU:00
ACTION NEIDED:
Cre�ted by: Wendy Hi�tt I?Ate Created: 2017-08-08
ACTION TAI�€EN:
...�._..:�'_�^'l_��...__.._......_..._..� ���...._...___ ...�... .._.._..._.._.._.. ,
Status: In Progress Sabmitter Has Seen r.
ContActed
Date Com4►leted: � �S� ��� Completed by: � �
� a