Meter swap !
Request Number: 15990
Public works Division
Service Request
Problem Address: 301 Longfellow St Requested By: Blanca
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 61 Z-323-2675
Scheduled te• 2017-06 1 Scheduled Time: 11:30:00
l s' .'�p
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 201�-06-14
ACT[ON TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
�j '�� � - �7 �y��
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, �o�,�����d�eY ��l- � ��bd -D �l
„ Water Departenent
�431 l�raiversity Avenue NE SQ ,� / �.7� �
Fa�d9ey,MN 55432 ���
763-572-3566
�/`"�e hereby authorize the City of Fridley and/or its employees to do what is necessary to
r�place the water meter. (a�nderstand that the nroperty owner is 1ia61e for the water line from the main to the premise and all interior
plumbing. (Per�'rty�ode 4cD2.06j 1 atso ho4d the City of Fridtey and/its employees harmiess for any dass�ages�hat may ocwr while doing this
operation. This+to incfude,but not fimited to valves,piping,wal[s,floors or the curb stop box and seroice line. In vnderstand 1 am aiso require
Lo obtairs a permit prior to arry wortc,if necessary.
F9NA!MEl'ER READING(o1d meter) ���� � P��
Name: v�" Address i�.,� ' ����-V�� ��
� �j
Phone Number � � �� ^ 6�pate � � !��'��
Signatur �Y � � Witness Signature ��"'"�'
�LD IVlETER# _ '� C )�� �~ l �
OLD READtPI�i_1...1 `> �� � �( 1
�E� M�,-���_ �-I�1�2��c�
NE�A/READIN�;�
E�T# � i��j�� 1�
FRIDLEY CI�'Y CODE
C9�A�TEt�4�2eWATE6t,STOfiMI UVATER tAND SANITARY SEWER
A�MINISTltA�'!ON
(3�ef CBrd 1Vo 113,464,565,566, 629,538,662,922,988,1144, 1156, 119�)
4Q2.5 PERNIIT FEE
Prior to�onstructing�r repair of any water of sewer line conneding the existing municipal system and any house or buiiding fo��rhich the
appiication is made,the owner or contractor shati be required to obtain a peranit for such connection,and shail pay a permit fee as provided irt
Chapter 1i of this�ade. After such connection�as been made,the Water and Sewer Department shal!6e notified. ifi shall be unfawful to cover
any connecting line until an inspection has been made and such cannection and the work incident thereto�as been approved by the City as a
proper and suitable connection.
4tIZ.06 l2EPAIR5 AND NtAINTENANC�TO CONNECTION
Afiter the initial connection d�as been made to the water service curb stap box or the sewer iead at tfie property line or a water seroice lead has
been�xtended to the pr4perty line for connection,the appficant,owner,or occupant or user of such premises shail be liable for al(repairs
rec{uired to any water line and sewer lines necessary fo�connection of the premises from the main to the pr2mises. lf the property owner
requests maintenance ser�ice or repairs be perPormed by the City,#he property owner sha11 be charged for the costs af the maintenance andJar
repairs,inciuding necessary street repairs at a rate set annuafly by an administrative policy. It shall be the responsibility of#he applicant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main inctuding debris clearing or
root cutting and to maintaire the water senrice curb stop box for operability and at such height as wift ensure that it remains above the finished
grade of the iand or property, (Ref 638,115�,1191j
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I�tc�cs
City of Fridley
Water Department
Address ���7� � c�f��r�u,�
Name ��/�f`�( ,s�.�/c�UG'C
� .
Date s—%�` �CJ �
Old Meter Number � �. �� �
Old Meter Reading C'
Replacement No. �,���OS ,��
Replacement Reading O
Replacement Make ��'
Remarks: �/�� /�ara� �v �ras� �A�-''
wti�..t�rz� (j�-cJ
Signed
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