Meter Swap Request Number: 16007
Public works Division
Service Request
Problem Address: 550 Kimball St Requested By: Mrs Ziebart
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-784-0528
Schednled Date: 2017-06-20 Scheduled 13me: 09:00:00
---L
Gl � a.rv-�
ACTiON NEEDED:
`
Created by: Wendy Hiatt Date Created: 2017-06-15 ,
,
ACTION TAI�N: ��, ,
{���
_.._.........._ .__.__......__..........__............_._W._._____ ..._._._._._.._._.._.._.____..._........_._...._ .__...._ __.� �
.�
Status: In Progress Snbmitter Has Been �.
Contacted
Date Completed: Completed by: `
` �ity of Fraclley
• Water�epaa�tsvs�en� �� —�� 21S 'T � �v�
�431 lJniversity Averaue NE �` ,,,�,[
Frid9ey,MN 55432 � -f'f- (�'�G��
7fi3-572-3566
` . 1
�/we L , ���� �1 � �C��d� r-f-h hereby authorize the City of Fridtey and/or its employees to do what is necessary to?
repiace t e�w�ater meter. !understand that the property owner is iiable for the water line from the main to the premise and all interior
plumbing. (Per�ity code 402A6) 0 also bold the City of Fridiey a�d/'�ts employees harmiess for any damages that may occur while doing this y
o�eration. This to include,but not limited to valves,piping,walts,floors or the curb stop box and service line. In understand l am also re�uire
t�`abtain a permifi prior to any work,if necessary,
f
:�:r�'
�FINA!METER READttYG(oid meterJ_��'(� 6��
Name�� " �!� • ��.�
i��t.�/� .2 f ��a. Address
Phone�Iumber p� �I p�0 (�
�
Signature Witness Signatu
OLD METER# ��`j'O���
OLD READING� ('� 02�`� S�D ^
NEW METER# ` l�l�°�� l
NEW READINC'i O
EfftT# _ ��O���,�j�
FRtDLEY CITY CODE
CHAPTER 402.WATER,STORNI W�TER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERAAIT FEE
�'`�'' Prior to sonstructing or repair of any water of sewer iine connecting#he existing municipa!system and arry house or Iwilding foc which the
� appfication is made,the owner or coritractar shafl be required to abtain a permit for such connection,and shall pay a perm�t fee`as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shali be natiEiect. It shail be.unlawful to cover
any connecting line until an inspection has been made and such connection and the worh inadent thereto has been approved 6y the City as a
proper and suitabie co�nection.
402.06 REPAIRS APiD MAINTENANCE TO CONMECTION
After the initial connectivn has been made to the water seroice curb stop box or the sewer(ead at the property line or a water senrice lead has
been extended to the property line for sonnection,the applica�,owner,or occupant or user of such premises shall be liabie for alt repairs
required to any water line and sewer lines necessary#or conneetion of the premises from the main to the premises. If#he property owner
requests mair�tenance service or repairs be perfortned by the�ty,the property owner sha(I be charged for the costs of the mainrtenance and/ar
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibii'ity of ihe applicar�t,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mair�tain the raater senrice curb stop box for operability and at such height as will ensure that it remains almve the finishec!
grade af the land or property. (Ref 638,1156,1191)
O 3-��
?�3� �-s-7 a-���
City of Fridley
Water Detiartment
Address_„��C� i�-I r„� b���� 5 �
Name L. i 1� ► ��'l � r�, ��-��
Date ( `� g "-� {
Old Meter Number v� Od O � $ �
Old Meter Reading 66 � �G
Replacement No. s�� C� �i �'
Replacement Reading
Replacement Make 4� �f
Remarks• �`L� �.��
Signed �=
,
'�:,
�
�'
�