Meter Swap R
� Request Number: 15709
Public works Division
Service Request
ProMem Address: 7837 Peazson Way Requested By: Brian
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nwnber: 763-355-0932
5chednled Date: 2017-06-07 Scheduled Tlme: 09:00:00
� �J G�.r� �
ACTION NEEDED:
Created by: Beth Kondrick Date Crexted: 2017-06-01
ACTION TAi�N:
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Status: In Progress Snbmitter Has BeeH �,
Coutacted
Date Compteted: Completed by:
�CO- 1 -' ��l T� �Or'
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�r�„���raa�eY �j� 3� ���(.� �� ���-
s water Departr„ent
� 6431 l�niversity Avenue NE � � ���J�
Fr�dley,MN 55432
763-572-356�
��'''�e heret�/authorize the City of�ridley and/or its employees to do what is necessary to
replace the water meter. t understand that the property owner is liabte for the water line from the main to the premise and all irtterior
plumbing. (Per�ity code�02.06j 1 also hold the City of Fridley and�ts employees harmless for any damages that may occur while doing this
operation. This to irtclude,but not limited to vahres,piping,watts,floors or the curb stop box and service tine. tn understand l am also requir�
to abtain a permit prior to any worlc,if necessary.
FIPIAL METER RE,4Dtf�{G(o�d meterj ��c�l�.J� ��
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Piame: ���� Acld �'(,"v' v8�(�- \J'�
' Phone Number�� ��� te�� �—' 1� 1
Si re _ Witrsess Signature
OtD METER# ��� v t v� �
OLD READING _ � � �O��V
NEW METER# '�t 1��it� �1 ��
NEW READING �
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FRIDLEY CITY CODE
CHAP7'ER 4Q2.WATER,57'ORM WATER AND SAlMlTARY SEWER
ADMINISTRATION �
(ttef Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERflA1T FEE
P�ior#o constructing or repair of any water of sewer line conaecting the existing municipal system and any house ar building for which the
application is made,the owner or contrador shall be required to obtain a permit for such cannection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Oepartmerrt shall be notified. It shall be unlawful to cover
any connecting line unti!an inspection has been made and such connection and the work incident thereto has been approved by#he City as a
proper and suitable connection.
402.06 REP�IIRS AND MAIRITENANCE TO CONNECTION
After the initlal connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the app(icant,owner,or occupant ar user of such premises shall be Ifable for all repairs
required to any water line and sewer tines necessary for connection of the premises from the main to the premises. ff the property owner
reques#s mairrtenance service or repairs be performed by the C'rty,the property owner shall be charged for the costs ofi the main�tenance and/or
repairs,including necessary street repairs at a rate set annually by an admi�istrative poliry. !t shall be the responsibility of the applicarrt,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mair�tain the water service curb stop box for operebility and at such height as wiU enwre that it remains above the finished
grade af the land or property. (Ref 638,1156,1191j
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Address ''
Name L„�Nh �
Date 1 t��l(`D`(� '
Old Meter Number� �
Old Meter Reading �9
Replacement No �( ���!�� �
Replacement Reading �
Replacement Make--t��
Remarkss "7"6ppE�p �
Signed