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Meter Swap { ` Request Number: 12359 Public Works Division Service Request Problem Address: 7310 Jackson St Requested By: Robert Nawrocki Departme�: WA'IER �.e�s: 7310 Jackson St Fridley,MN 55432 • Prol�em/I�aue: INSTAL,L AMR METER Phone Number: 763-780-4249 ScLeduled DsCe: 2016-12-16 Sc�eduled'Iime: 11:00:00 � AC'RUN NEEDED:install AMR Create�by: Beth Kotdrick Date Cresited: 2016-12-05 ACIION TAI�N: I h�,1� � � � Sts�tus: In Progress 5nb�itter H�s Besa C ContAeted Date Completed: Completed iry: Hours I - I � � 2 � � . City of Fridiey � � �� Water Department �(,j + 6431 University.Avenue NE Fr�dley,MN 55432 �v�s--� �Cj��;--(��-- • 763-572-3566 �/�e hereby authorize the C'ity of F�idley and/or its employees to do what is necessary to replace the water meter. t understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) t atso hoid the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. in understand t am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter� �� Name: �� Ivla 1•J� r�� Address �3 �� J �� Phone Num ��v�'� —1�'T� Date �Z� �b !� XSignature � Witness Signeture g OtD METER# �7� 2'� � �2� OLD READIN6 lJ J J G-i J�O NEW Mk?ER# �� '�� ` � NEW READING � ERT# 10 �U � �� Z� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMIN ISTRATION (Ref Ord No 113,464,565,566,629,638,562,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer t�ne connecting the existing municipal system and arry house or bulldlrqj for whid�the application is made,the owner or contractor shall be required to obtain a permit for sucb rnnnection,and shatl pay a permit fee�provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shail be notified. R shall be un(awful to cover any connecting line until an inspectian has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connedion. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connectiort has been made to the water service curb stop box or the sewer lead at the property line or a water servioe lead has been extended to the properly line for connection,the applicant,owner,or occupant or user of such premises shail be Ifable tor all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the C'�ty,the property owner shail be charged for the costs of the maiMenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applipnt, owner,occupant or user to perform standard maintenance af the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as wil!ensure that it remains ab�ove the finished grade of the land or property. (Ref 638,1156,1191) �'�. t�" ,• y �„ �s y � � A�f � �`"1 1:� �' 3 ;-��' '��. i th r cfty o! Fridiey Nater Denartment r Address � 3 �b �a..G�Sb R Name � �,0.W CK' t Date '�� - � �� O1d Meter Number �a d'd • � Old Meter Reading � � � "4� Replacement No. � � �� Replacement Reading Z Replacement Make � Q�r Remarks: 0�'.I �`G� �' '� � S igned� �'