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Meter Swap � , . REQUEST FOR SERVICE REPORT CITY OF FRIDLEY Reference Na. Date: � ��1—�(� . Request Type: Entered By: Department: Citizen Name: �A``�� Address: "l �Q 'rj ��'��J� ��R Phone Number: Scheduled Date: Property Owner: 4ocation Details: Request Details: Activn Taken: � �,.�� .`��}�p d��4 W (��•� �S �.v�-z�-� C��`�J ��' �P��.�t�`' �� Res onsibfe Person: �`-� : p Approver: Completion Date: �(�_1'? Citizen Notified: ' Y« �`�y��4e� ��y �I G/��J" �`D� �ater�e�saa�rv�ero� ��,� i 643�.!lnav�rsity Aven�se NE �� FrBslley,MN 55432 763-572-35fi6 ��'Afe hereby authorize the C�ty of Fridley and(or its employees to do what is necessary to re�lace the wat2r cnet�r. {understand that the property owner is 9iable for the arater line from the main to the premise and all 9riterior plurnbing. (Per�ity code 402.06j I also hold the City of Fridley and/its employees harmless#or any damages that may occur whife doing this operation. This to include,but not limited to va(ves,piping,wa{Is,#loors or the curb stop box and service iine. in understand l am also requirE to abtain a permit pr6or to any wortc,if netessary. FINAL METER READItVC:{otd meterj_ � � 1 l �� Ptame: Address f ��``��C"'� r.t`''�`� Phone�lumber Date "- ��"' Signature � Witness Signature � � o�D ��R.� __ O� 5�1 `�a1� OLD fi�ADlNG � � � � NEW NIETER#__ L {�� S i� NEW READ{NG _ Q� E�T# `��.yt � I�'� FRIDLEY ClTI CODE CHA�'1'ER 402.WATER,STORM WATER A{YD SANlTARY 5EVNER A�MfNISTRATION �I�ef Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j 402.5 PERMlT FEE � Priar to�onstructing ar repair of any water of sewer line connecting the existing municipal system and arry hause or buiiding for uvhich the application is made,the owner ar corrtractor shali be required to obtain a permit for such connection,a�d shalt pay a permit fee as provided in Chapter 11 of this+Code. After such connection has been made,the Water and Semrer Departmert shal(be notified. it si�aU be unlawful to oover any connecting line until an inspection has been made and such cannection and the work incident thereto has beert approved by the C'ity as a proper and suitable conneckion. 402.06 REPAIRS AND MAIPlTENANCE TO CORINECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water servic.�iead has I�een extended to the property line far cannecfion,the applicarrt,owner,or occupant or user tyf such premises shall he tiable for ali repairs required to any water tine and sewer lines necessary for co�nection of the premises from the main to the premises. �f the property owner requests rttairrCenance service or repairs be perfatined by tfie C'rty,the property owner shall be charged for tfie costs of the maintenaace and/or repairs,includi�g necessary street repairs at a rate set annualiy by an administrative policy. It sha(I be t(te responsibility of the appiiqr�t, owner,occuparrt or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearirtg or rvot cutting and to mairrt-ain the av�ter service curb stop hox for operabitity and at such height as will ensure that ifi remains above the�nished grade af the land or property. (Ref 638,1156,11919 __ ...m�_....._ .�_ ___._�.___��__ ...�.�.. ..� l�' ' � l, � �� __.�. .___..___..._.......... _.._.._...._ __..__� � _ __... ; � ; ''!i�% � -_ ---- - ------� _....------- __........__..._.____.� _ � � _........___......... .:......_.� � � I � � � { � � �N'►�✓ � "Vl n Q✓ � � .� � �� -� ��s � _ -�„� ��,� � 1 � . � _�� 1�.�� -�► ��*�� =�a� �� _ ��c �� ct� =��a ��9oec =� �� nn =� ��M �� 3 =�'1 Z�.4�'Jt� �� -Zl-l� �� Q� �j �� JfI�� j