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Meter Swap Request Number: 15649 Public works Division Service Request Problem Address: 8101 Ruth Circle Requested By: Robert Departmeut: WATER Address: No address provided Problem/Issuec INSTALL AMR METER Phoae Number: 763-780•S 171 Schednied DuEe: 2017-06-01 Sc6edulcd'IYme: 1 I:OU:O(! sfi AG7ION 1�tEEDED: Created by: Wc�ndy Hi�t DaEe Crented: 2017-OS-31 ACIION TAI�N: � �.��c�c .��., _......_.._ _...__.____ _�... ..............__.._.. __._._ _ Status: In Progress ��her Has Been r, �;. Co�acted Date Com�eted: � _ ' .� 1� Completed by .S�k� � �it�o�F�adley � � . 1ht���r Depas��ttent �� (,� ..-� f l t� � �431�niorersity A�reroue NE ✓ � Fraclt�y,MN 55432 C � �. ��t� 763-572-35&� v tI`"�e hereby authorize the C'ity af Fridfey and/or its employees to rio what is necessary to repiace tfie water meter. i undentand that the property owner is{iabte for the water tine from the enain to#he premise and ali irtterior plurnbing. (Per�ity code B02A6) 1 also hold the Crty of Fristtey andrts employees harmless for arry damages that may occur white doing this operation. This to inctude,but not limited to vahres,piping„walts,floors or the curb stop box and service tine. tn understand t am atso requir� to obtain a permit prio�to arry work,if necessary. FfNA!METER READiflt6(etd meter} `� Q � V� t-,� V Name: 1�-d1V��� Address � f � \ �,��V�„ Phone lvumber V��� ��'� ����p� �Q`'– t, '�" l. Si nature � Witness Signature _—~ Ol.D METER# �J � ✓����� OLD READtNG ���`�� ✓ � ti��,��-�R# ����C� ��3 NEW READtNG � E�,-# ���� � �� i fRtDlEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADM1MlSTRATION � (Ref Ord No 113,464,565,�66,629,638,662,922,9$S,i144,1156.1191) 4Q2.5 PERMiT FEE - P�ior to constructi��or repair of any water of sewer line conaecting the existing municipat system and any house or bui[ding fior whicfi the application is made,ttte awner or contractor shaii be required to otrtai�a permit for such conaectian,and shall pay a permit fee as provided in Cha�ter 11 of ehis Cade. After such connecCion has i�een made,tfie Water and Sewer Department shall be notified. ft shail be un[awful to cover any connecting line urrti!an inspection fias been made and such connection and the work incident ihereto has been approved by the Crty as a proper and suitable connection. 402.06 REPAIRS AtYD MAtNTENANCE TO CONNEC7'ION After the initial connection has been made to the water service curh stop box or the sewer lead at the property line ar a water service(ead has 6een extended to fihe property line for connection,th¢appficarrt,owner,or occaparrt or user of such premises shaU be liable far af(repairs required to any water line and searer lines necessary#or connection of the premises from the main Co the premises. If the property owner requesfis maintenance service or repairs be performed by the C'rty,the property owner shat!be charged for the costs of#he mairrtenance and/or repairs.including necessary street repairs at a rate sst annualiy 6y are administrative poficy. It sha!!6e the responsibifity of the applica»t, owner,occupant or user to perForm standard mairrtenance of the sewer senrice line from the premises to the main including debris dea�ng or root cutting and to maintain the water service turb stop box fo�operability and at scrch height as witt ensure t6at it remains above the fiaished grade af the tand or property. (Ref 638,1156,1191) � � �; —)� r , ��� ��� . , ' idley / '�j�`�Zp�" Water Department t f �--�C��%j�L) ; Address �� O/ �:.�� �1 r-� 1�! Name �{J�� �f� � e..L, d 1,�-, � Date�' / (� � Old Meter Number �/ /� � � Old Meter Readin �,� ��"�� Replacement No: �- ,� Replacement ReadYng � . z � Replacement Make__ �- �s4" ' • � E # ,��_ , , ,. � .r�^^'. � . '.,.. �� eplace n RT# y t . --��-- � ` ' ? ''�' }� Rema �- !^���1c.r-- •' �� � �' � Signed� ;�;�� J � S la� ". I [$ � ��� �{ j> g � .. ^ �.:1. '� �d�f�� � ' V�•�'