Meter Swap _ _ Request Number: 13117
.
Public Works Division
Service Request
Problem Addresa: 7419 Lakeside Rd Requested By: Jacob Vu�ceut
Depnrtme�: WATER Address: 7419 Lakeside Rd
Fridley,MN 55432
Problem/7ssne: INSTALL AMR METER Phone Num6ers 651-214-4469
Scheduled Date: 2017-02-02 SchedWed 7ime: 01:30:00
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ACTiON NEEDED:
Created by: Beth Kondrick Date Cre�ed: 2017-01-26
A N TAI�N:
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Statua: 1n pragress Snbmitter Hps Been �,.,
Contncted
Dxte Completed: Complettd by:
�. - 2 - ( �, �v�-
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�rvatea-�epartrnent
5�3].�Orsivea-sityf Avenaae NE � � � �
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Fridley,6U16�! 55432
753-572-3566 ""> � �� ���� (�t�` �:
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, �,,"'�e hereby authorize#he Crty ot Fridiey and/or its empioyees to do what is necessary to
replace the water meter. i unclerstand that�he properry owner ss tiabie for the+nrater line from the main to the gremise and a!1 irrterior
piumbing. (Per Crty code 402.06j i also hold the C'rt�uf Fridley and/'rts employees harmless#or any slamages that may occus while doing this
operetion. This#o include,but not Bimited to valves,piping,wails,floors or the curb stop Iwx�nd�nrice iine. 1n a�nderstand!am aiso requir
to obtain a permrt prior to arry worlc,if necessary.
EIAiAL IIAETER READIAiG{al meter) � � � �D �O
, /� �1� ^ ` 1q � f _1
Name: �L���[�/ � Address � � V \ � �t� �i�l
Pbone Number(!/�r 1/ � Y��p� �� l�'� ��
,�_.�---'"'�^'....
Signature Witness Signature
OLD METER#_� G�I� c���
OtD READtNG� - 1 `I `� D�V
NEW METER# "{� O � � �"�
NEW READ1111G t /
ERT#� � v .�
FRIDLEY CiT1f CODE
CHAPTER 402.WATER,570RM WATER AND SANITARY SEWER
ADMINISTRATtON
�Ref Ord No 113,4G4,565,566,629,638,662,J22,988,1144,I156,i191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing muniapal system and arry hause or buildi�for which the
app(icat�on is made,the owner or coritracto�sha(1 be required to obtain a permit for such wnnection,and shaU pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,tlte Water and Sewer Departmertt shall be notified. It shail be untawfui to cove
any con�ecting line until an inspection has been made and such connection and the work inciderrt thereto has been approved fiy the City as a
proper and witabte connection.
402.06 REPAIRS AND MAINTENANCE TQ COfMNECI'ION
After the initiat connection has been made to the water service curb stop 6ox or the sewer lead afi the property iine or a water se�vice iead f�as
been extended to the property line for connection,the appiica�,owner,or accupar�t or user of such premises sf�alt be liaWe for a0 repairs
required to any water line and sewer lines necessary#or connection of the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be perFormed by the Crty,the proper�:yy owner shali be charged for the costs af the mairKena�e and/or
repairs,including aecessary street repairs at a rate set annually by an administrative poliry. tt shati be the responsbility of the appiicant,
owner,occupant or user to perform standard mairrtenance af the sewer service line from the premises to the maia inciuding debris dearing or
roo�t cutting and to mairrtain the water service curis stop box for operability and at such height as wili ensure that�t remains afiove the flnished
grade af zhe land or p�operty. (Ref 638,1156,1191)