Meter Swap �
• Request Number: 16013
Public works Division
Service Request
Problem Address: 124 Longfellow St Requested By: Janice
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-221-4387
Scheduled Date• 2017-06-16 ,._..t Scheduled Time: 07:30:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-06-15
ACT[ON TAI�N: � � ^
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Status• In Progress Submitter Has Been r
' Contacted
Date Completed: Completed by:
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Wat�r Depart�a�nt � � /l���
' �431 l�niversity Avenue NE Y
F�odley,MN 55432
7�3-572-3566
+/'iVe hereby authorize the City ofi Fridley and/or dts employees to zio,wrhat is rtecessary ta
replace the water meter. i understand thair the�roperty owner is liable for the water 9ine from the anairt#o the gremise and ali irtterior
plumbing. (Per�Lity�ode 402.06j �also hold the City of Feidley and0its empioyees harmless for any damages that may occur while doing thls
operation. This to indude,but not limited to valves,piping,waNs,#ioors or the�ur6 stop box and service line. In understand 1 am also requirE
to obtain a permit prior to any work,if necessary.
FBNA!ME'�!�READtiVG{o1d meter) � `� � I�.J
Name• �Vil,�i G� Address � �� \ L�3�"�°j�� �'
Phone Number 1��^��t �' � J g��ate �� Y� ~ ��
x5ignature �P�U�'Y�/�� Witness Signature
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FRIDLEY CI'9"Y CODE
CI�A�TER 402.WA3ER,S��RMI UVATER AND SANITAItY SEWEit
A�MINISTRA�'IOi�!
�Re�€Orsl No 113,464,565,566,529,638,662,922,988,1�.44, 1156,119�)
402.5 PERNIIT FEE
Prior to sonstructing or repair of any water of sewer line connecting the existing municipa(system and any house ar bui(ding for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
�Chapter 11 of this Code. After such connection has been rnade,the vNater and Sedver Department shall be notified. It shall be un(awful to cover
any connecting line until an inspecCion has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
40Z.06 l2EPAIRS AIVD lVIAIN'1'ENANCE TO CONNEC'�ftQN
After the initial connection has been made to the water service curb stop box or the sewer(ead at the praperty line or a water service lead has
been extended to the property line for sonnectian,the applicant,owner,flr occupant or user of such premises sha41 be liab{e for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main ta the pr2mises. If the Qroperty owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenartce and/vr
repairs,inciuding necessary street repairs at a rate set annual(y by an administrative poliry. !t shalt be the respansibility of the applicant,
owner,nccupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
roat cutting and to maintain the uvater service curb stop box for operability and at such height as will ensure that it remains above the finished
grade af the iand or�property. (Ref 638,1155,1191�