Meter Swap �o�'y���s�d�e� r i�`�"
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763-S�Z-35��
e�'"r� herebr�ae,cthorize the Caty o�t F,ridiey and/or its empiayees to�a what is necessary ts
r��iac�the urater�neter, !�araderstand tteat the�aroper��ownee is�iable for xiae�ter line�rom ihe�rtain to the premise and all ir�ter9or
�9uers6ing. {Per�ity zode 40Z.�6j 6 aBscs i�oid the�'rty�f Fr�cd9ey sced�ts smployees harmtess for any daraia�es that enay ocwr while doirtg thi;
oqseration. 7'his to�nclude,but saot iimified�o vaives,�ipirtg,�vaids,f9oors�r the curb stop boz ar�d service line. dn undee�stand 9 arn atso requi
to abtain�perrsait prior to any�v�orfc,if�ecessacy.
FlNAAL METER READtRlG{olci ss�eterj � �a ��
�c' �
Narrae: 11�/l,� LY� r'�� Address_ � I� N ' -t-�`vn bQ r � ` L'�
rr '�!
���.��
. Pt�one Alumber �GZ ' �� " �-I Date �"— t ' '� l�
�Signature � Witness Signature ^—_
OLD 9Vl{E�'ER# � V y �
�L� ��,��N� a 1 �D 2`� 0
�����-�-��# '�� ��� ���d _.
��������� C�
E#�T# � � (� ( � J ��
______._
FR9Dt�Y�lTY�ODE
��@A�1'ER 4tD2•�Nl�T�R.S9'�R�li�'rA�A7'ER�iRID SANiTA6�Y SEPNER
!�►�fl149N9STRA1'IOtY
��ef�rcd No 9,13,464,SSS,5�6, 623,538,662,922,988, 1144,1156,1191j
402.5 PEl2MIT�EE •
� Pritsr to�onstru+cfiing ar repair o�f any water af sewer iine connecting the existing municipal system and any house or buitding for which the
appiication is made,the owner or cornractor shail be required to ofatain a per�mit for such conoection,and shail pay a permit fee as provided ir
Chapter 11 of this Code. After such connection has been made,the INater and Sewer Depar+tmerrt shafl be notified It shat(be unfawfut to co��
any connecting line untit an inspection has been made and such carsnestion and the work incider�t thereto has been approved by tt�e Crty as a
�roper and suitabie co�raection.
402.06 1tEPA1RS A1VD MAiFYTEf+tANC�TI�COMNECTIOiV
After the initiat sonnectsan�as been made to the water service curb stop box ar the sewer lead at t�e property line or a water seroice�ead has
beert exfiended to the proper�;y line for cannection,the applicarrt,awner,ar occuparrt ar user of such premises shall he iiab{e for ail repairs
required to ar�y water tine and se�nrer lines necessary for cortnecCiart of the premises from the main ta the premises, (f the property owner
requests mairnenance serv�ce or re�airs be performed by the C'rty,the property a+uner shaU be ch�rged for fihe costs of the mairnenance and/o
re�oairs,inctuding necessary street repairs at a rate set annuaPfy�y an administrative policy. It shai(be the responsibi(ity aFthe applicarst,
owner,occuparnt ar user to perform standars!mairrtenance af the sewer service line from fihe premises to the main includ'ang debris ctearing or
root cutting and to maintain tt�e water;ecvice curb stap 6ox for ope�abitity and at sucfs height as will ensur�that it remains�bove fihe�nished
grade of�he(and or properly. (Ref 638,3.156,1199.)
f
�
/ ,
y Request Number: 16630
— — — — — �
Public works Division
Service Request
ProMem Address: 1510 N Timber Ridge Reqnested By: Beth Pickering
Department: WATER Address: No address provided
Probiem/Issue: INSTALL AMR 11�TER Phone Number: 763-586-0931
Scheduled Da • 2017-08-11 � 5cheduled Time: 10:30:00
� -��
ACTION NEEDED:
Created by: Wendy Hiatt DAte Created: 2017-08-Q9
ACTTON TAI�N:
1l ._ �
.................... _��..�.�__......_._w..... ....:�� _._._........_..............................__.__....._______......................_..........__ .__._... ______._..___._.__
....,�
Status: In Progress Submitter Has Been r,
Contacted
Date Completed: - Completed by:
► � �
`� ���- �-7 � �o,�
-�
� �;3-1 a-o�?�,�i5-51 C�v
� '� INSTALLATION
�.n,� �NDARD WATER METER
FRIDLEY
Address ��1� ���M�Z-�`��—
Name �����C.����(7
Date I l-la I D
Old Meter Number ss5
Old Meter Reading 3� ��
Replacement No. �� v� d��
Replacement Reading �
Replacement Make���t��
Remarks: � �U� ��Z
Signed: ���^�,�/ _