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Meter Swap y Request Number: 13319 Pubtic works Division Service Request Problem Address: 7501 Lakssi�Rd Requested By: Natalie Olsen Departme�: WATER Address: No address provided Problem/Issue: INSTALL E1MR METER P6dne NMnber: 763-783-5977 n _ ' Schednled Date: 2017-02-21 Sc�dnled Tlme: 01:00:00 �—�-- } S,� � ,::. . ACl�N NEEDED: Created by: Wc7►dy Hiatt Date Crerted: 2017-02-07 ACIION TAI�N: !����'�l � ,� � _ :� �. Status: In Progress Submitter Has Been r Co�acted D=te Completed:a.,���.'J'�_ Completed by:�a�� v �� �_ � � �____. ,�..�,.,.a,..oa..,o� �435.i�nivQrsi�tyr�alve�s�e dY� <j^,,� �L ( ���cltey,61e1N 55432 �i � 753-572-�566 ' �. . v� 31 �- � � � 1 � '/'"°� hereby authorize�#he�'riy af�rnslley andJor its empioyees to slo what is necessary replece the water sneter. 1�nderstand that the property owner u liable for the�ratee line from 4he main to the premise and ali irnerior plurrabing. (Per Crry coaJe 402.06j i also hold the City�of Fridley and/'rts empioyees harmiess for eny damages that may occur rrhile doing tF o�aeration. This fo anctude,?bufi aott limited io valves,piping,walls,floors or the curb stap box and service line. In understand!am also req to obtain a permit prior to any aror4c,if aecessary. �BTYAL NIETER READIAIG(oid mefierj O �� � V V O �ame: N�A.�w.��� �is"Cy� Address�_�� � ��J�1 �� �' PhonelYumber `��� �V�'"J f�, Date a"� �� ' �,� Signature YV�ess S+gnature --.• OLD MET�ER#�(��, � 1 � ��- OLD READtlYG_ � �v d�� NEW METER# � � I � �� � � NEW READIAtG � ERT# � � � � W 3 C�3 . FRIDLEY CiTY CODE CHAPTER 402.WATER,STORM WATER AND�kNITARY SEWER ADMI}IIISTRATION (Ref Ord No 113,4�&4,565,566,629,638,662,922,988,1144.,1156,1191j 4Q2.5 PERMIT FEE Prior to constructing or repair of any water of seyver Sne connecting the eaisting munici�at system ar►d am/house or buildir�fvr which ihe appl�cation is made,the vwner or corrtractor sha(!be required to obtain a permifi for such connection,and shali pay a permit fee as provided Chapter 11 of this Code. After suc(�connection has been made,the Water and Sewer Department shali be notified. tt shail he unfawful to co arry connecting[ine u�tii an inspection has been made and such connection and#he work incadent thereto has been approved by the City as a proper and sui#abte connection. 402.06 REPAiRS AND MAIRI'I'EAIqRICE TO CONNECTION After the initiat connection has been made to the water service arb stop t�oK or the sewer fead at the prx�perty itne or a rrater xnriae lead ha been extended to the property line for connection,fihe applicarrt,owner,or oscc�partt or user of such premises shali be Iiat�ie{nr all teµalrs required to ar►y water lirte and sewer lines necessary for conrtection af the premises from the main fio the premises. i�the property owner requesis mairrtenance service or repairs be perFormed by the City,ihe proper#y owner shall be charged fo�the�of the mairrtenance and/ repairs,inctuding ne+cessary street repairs at a rate set annuaily by an administrative poYry. it shafl be the responsibitity o�f the appiicarrt, owner,ocsuparn or user to pe�orm standard mairrtenance of the sewer service line from the premises to the main dnduding debris dearing rn root cutting and to mairrtain the water service curb stop box for operability and at such height as wili ensure that it remains above fihe finishec grade of the land or property. (Ref 638,115fi,1141� � �.I � � � � � � � � � � � � � � � � �- _ __ ----; � � � � � � - �- , ; � � � � � � � � � �. � � � _ � � � .3 � � �; � � � � � � � � N � � ,� � � - _ � � � � � � � . � � � � � � .� - � � � J � � �- � p - � W �I �� � � � � - � c� � � � y — � � . _ — � � � � � - ,. � � � � � � � � � � � �- � � � � p —� � � � � � � � � _ 0 � . � cv � � � _ � � � � � .. � � �S � � � n' � � � .� s� . 2 � a� � � ° . '� � � � � � _C.� � _ � _ � � R�q�t fc�r Ser�riae R�pvrt Ci#y c�f Fndley ���: s�-rt2-5a2a o��: 7ar��2t��2 Re�,eslt Type� sew�r back-.,p�edc c�r�in �r#�es�By: wenciy��t tJ�ep�t: Sew� t`aEi�1V�e: �iata�e(�Isrx� Adsfess: 75�1 LAI�SIaE RD NE Caltsac.i€P�ane: 7C�.i-783r59T1 �e+d [k�te= t�/l6l.t�12 1=15 RM �'�?S(�1�. �+[7w�er: Lacatian�#a�s: , Request Details= Bac�n�_ t��c.+efc C�t�►Ma� Ac�n Tak�: � �-� . „ . � p� ` � � �i���1�iZ \`� U1�k� V1bvV1��L-��� � � `�+ 1 � :, �� �,�,I a—��—� s � �v� � C�J�� `� , I � � � ; � � i , i 1 � � € { P � � 1 � � I � � ^� �Perstm� /�, � ,� �G ; l(J � �� — __... . _ ______...._. _ � _.,.____ �_._ _.._.. F ��'� Gort�letie�D�e: Giaz�Nd�ed l� I� �_l Z.— " � FF�t�qu�# fi�r�:r�e � �ity c�f Fr�cii�y �; �-�2 54�a i��: 10.d16t2012 EiEques�T�e= �/se�r s�'� �� [7�a�: �ew� ��� A�et3Fmr� Ad�= r�Q1 L�if_S���� . 76�783� �d�ie= 1�i1�12 l�flL111ii F'hnop+a�tt)++s�r� Ia��� Hequrat t)efa�s: "I1/�:u�ic�e � . �V�+i�ce. t.i�i�d�s. �I!a�cxrit�7'8-£�D�. 4'k G"��. 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