Meter Swap � Request Number: 13031
Pubhc works Division
Service Request
Problem Address: 7437 Lakesick Rd Requested By: Cheryl Theisen
Department: WA1ER Address: No address�xovidcd
Problem/Issiu: INSTqLL AMR METER Pho�Nnmber: 763-574-7333
Seheduled Date: 2017-02-07 Sc�edaled 11me: 02:00:00
.�._.-- �-,� �
ACIION 1�tEED�D:
Created by: Wendy Hiatt Date Cre�ed: 2U17-01-23
�ON TA�iiEN:
�ws�1,G� ��;
Status: In Pro ess ���er Has Beea r,
� Contactcd
Date Conpleted Completed by:
���r �� (`��,�' '"'�'' �`��l�' �.
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�!1/atea-�e�sartrnent
6431 Universit'/Averaue N� S� �a��
Fridley,MN 554�2 �
763-572-3566 , � �_y� 3 as u -�3
1/we hereby authorize the City af Fridley and/or its empiopees to do arhat is necessary to
replace the water meter. I understand that the prope�y owner is liable for the water line#rom Yhe main to the premise and all irrterior
pluer�bing. (Per City cocle 402.06) i also hoid the City of Fridley and/its employees harmiess foe any damages that may occur while doing this
operation. This to include,but not lim+ted Yo valves,piping,walls,floors ar the curb stop box and service line. In understand 1 am also requlre�
to obtain a permrt prior to any work,if necessary.
FBVAL METER READING(oid meter) � ��� � �v
Name: �' """ �� ���e, ` Address ��� �l lLL� �_��V►
Phone Number���`+��� r���� Date ���� ` ` —
Signature W3tness Signature '`— '
OLD METER#_ ` �` { � � 3 l�
OLD READlNG ���r S d
NEW METER# � � �v � / � `�
/
NEW READING �
ERT# G � �oC v C�C� U ,
FRIDLEY CI7'Y CODE
CHAPTER 402.WATER,STORt1l1 WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,9$8,1144,I156,1191}
402.5 PERMIT FEE
Prior to constructing or repair of any�vater of sewer line connecting the existing municipa{system and arry house or building for whid�the
application is made,the owner or comractor sha(I be required to obtain a permit for such connection,and shall pay a permit fee as prrnrided frr
Chapter 11 of fihis Code. After such connection has been made,the Water and Sewer Departmerrt sfiatl be natified. tt shail be untavvfvl to�ver
any connecting line until an inspection has been made and such connedion and the work inaderrt thereto has been approved by the City as a
proper and suitabie connection.
402.06 REPAIRS Ap1D MAINTEtYANCE TQ CONNECTION
After the initial connectiort has been made to the water service curb stop box or the sewer lead at the property line oc a water senrice iead has
been exte�ded to fihe property{ine for connection,the appiicant,owner,or accupant or user af such premises shaU be Iiable fo�atl repairs
required to any water line and sewer lines�ecessary for connection of the premises from the main to the premises. if the property owner
repuests maintenance service or repairs be perFormed by the C'rty,the properly owner shaii be charged for the costs o�F the mair�nance and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrattve policy. It shatl be the responsibility of the applicarit,
owner,occupant or user to perform standard mairitenance of the sewer service line from the pcemises to the mai�including debris clearing or
root cutting and to mairrtain the+arater service curb sfiop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)