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Meter Swap • Request Number: 12723 PuWic Works Division Service Req�yest Problem Addreas: 7301 Melody Dr Requcsted By: C�rie Arm�nd DepartmeHt: WA'IER Addre:s: No address provided Problem/Issne: INSTALL AMR METEIt Phone Nnmber: 612-834-7139 Sc�daledDrte: 2017-01-06 �Se`ednl�d . 09:00:00 c �-. AG'TION NEEDED: createa try: wendy xi�c nne created: 2017-01-at ACIION TAI�:N: �1 `��-�,�,I Ti � '"�� tl�� Statea: Ia Progccss 3nbmitter H�Beea C� Coataeted Date Completed: � �--� r l� Com�eted � City of Fridley Water Department 6431 Universiiy Avenue NE ��..-C�a' Fridley,MN 55432 � ,� � 763-572-3566 S o l g� g ��We hereby authorize tfie City af Frid{ey and/or its employees to do what is necessary to replace the water meter. t understand that tfie property owner is liable for the water line from the main to the premise and all iMerior piumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am alsa reguired to obtain a permit prior to any wortc,if necessary. FINAL MErER READING(old meter) v �C` " �`�' '" Name:_��e- ��"V�G-r`�(y Address �� ` ��d'� �r'� PhoneNumber lZ-- ��LI "` �� Date '"`� � � � ( / �-/1-.- ,��r Signature Wiiness Signature �J`�-- OLD METER# � U t�� 1,� ` OLD READtNG �� b v �� NEW METER# _�� READING � ��T# � U�� 1 �� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMtNISTRAI'ION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j 402.5 PERMIT FEE Prior to constructing or repair of arry water of sewer line connecting the existing munidpai system and arry house or buildirig for which the application is made,the owner or contrador shall be required to obtain a permit far such c�nnection,and shalt pay a permit fee as provided in� Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting{ine until an inspection has been made and such connection and the war�c incider+t thereto has been appro�ed by the Cty as a proper and suitable connection. 402.06 REPAlRS AND MAHYTENANCE TO CONNECTION After the initial connection has been made to the water senrice wrb stop box or the sewer lead at the property(ine or a water senrice lead has been extended to the property fine for connection,the appiicarrt,owner,or accupar►t or user of such premises sha�l be liable for afi repairs required to any water fine and sewer lines necessary for connection of the premises from the main to the premises. if the property owner requests ma4ntenance service or repairs be perFormed by the City,the properly owner shatl be charged for the oosts of the mairrlenance and/or repairs,including necessary street repairs at a rate set annua0y by an administrative pofiry. It shail be the responsibility of the applicant, owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main induding debris dearing or root cutting and to maintain the water service curb stop box for operability and at such height as wlll ensure that tt remains above the finished grede af the la�d or property. (Ref 638,1156,1191) - . . � � "�} � � ^� . . �};�: �� 5��yg�'I` � . ,x.�,f�;h�t� ?�� '��g �-� .' . t f�`'.� � . �`�� T..;�� ' eity of Fridley Water Deoartment Address � '�� . Name �� t �� G�'" Date �"`"' � �� Old Meter Number � � � ��+ � � Old Meter Reading � � � � Replacement No. � � � � � Replacement Reading Replacement Make �� °�Y' o Remarks• �`7� 1',�,2�✓"" �. �� S i ned �.�' :...� 5 �