Meter Swap . �
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` Request Number: 16646
Public works n;vision
Service Request
Problem Address: 1515 S Timber Ridge Requested By: William
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 651-261-0577
Scheduled Date: 2017-08-15 Schednled 1lme: 08:00:00
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ACIYON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-08-10
ACTION TAI�N: � �
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Status: In Progress Snbmitter Has Been r :��`
Contacted
Date Completed: � Completed by: C a�L� �� , �,
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��''�� here4sv�ae,atfsorize tFse�tt+�af�rsdiey and,�r�r its�?an�oio•�ees�o dv�rh�at is�aecessae^�
a��slaca the�rater�rae�2c, �ra�aderstand t�aat the properL�a!axraea�►s�iaisle fac xhe wa�es i'sne firo�na fi9'tee maar�tn�fte ar�satise and aHf ir�tter9or
�i�aa�a�s�ing. {@�e��'rt�{cs�de Af��.d26� �a�sca�aolc8�fie�i�+j nf�r�ctBey aracd,�its empiayaes,fiarmiess#or arna daaaeages�dhat�s�tay occe�r white 8oiesg�
ra�ea-�t9on. �is L�ie�c�s�de,4aea��acrt limite�d t�vaives,�aipic���rc�3ts,�9ooa�s or tt�e ruc�a sia��ao�and seruice iine. 4n urtderstacad�arse afscs��t
�s��datain a pea�s�ait�ar�or�o asay w��fc,�f nec�ssary_
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�2.5 PERMdS�fE
� Pr�Qr t�constrRactirtg oe�repair a�f any water of sewer line cannecting�fae existing m�nicipat sy5t�m and arty house or bui(ding�or whicft the
apqslicatiors is rnade,the a�rner flr carrtr�ctor shai!oe required to ahtain a permit for�unc�onnection,and si�ail gay a�ermit fee as prav+cted
�hapt�r�1 of ti�is�ode. After such connection has been made,ehe�Alater and Se�vec?epartmerst sf�ai(be notifiecf. !fi shaU be s�nlawfvi#o cc
any�vranecCing tine urrCi6 an ins�section has been made and such conrvectian and#ee�aos!c inaderrt thereto has t�een appro�,ed i�y the C'r,ty as x
�ro{aer arsd suitab�e conrtectioe�.
�02.06 �ZE6�satRS AaiiD 9U1,AtN'4'EAIANCE TO�COi+ttY£C'3'tOfK
After tfee snitial wonnectiora has�een rrsade'to ti�e avater serusce�rb stop box r�r�€ae se�r�r teat!at tf►e praperty lirte or a wrate�servicE;ead h:
been extended ta ti�e prvperty iine for connection,the applicarrt,awner,�r occupant csr a,iser aF such premises sha!!be 4iafsie for afl repairs
required to ar�y water line and se�nrer lines rsecessa►^�for conraectiorc of tt�e premises from the main ta iFte premiseg. tf the property aavner
requests nnairnenance seruice ar repairs be perfvrmed�y the t"a#y,tt�e property owner shall b�charged for the�aF the�rnairstenance and�
repairs,inciuding necessary street re�airs at a rate set artnuaily�yy an administrafiive�oiicy. tx shatl he the responsitsitity af the appiicar►t,
owner,occuparrt or user to�aerfarm standard rr►airrtenance af tile sewer service fine from the nrerrsises to The main inctucfirr�debc�fs ctearing o
root�utting and to maintain tt�e vuater;errice cur�a sfia�p 6ox for o�erability aad at suc.th height as wilf 2nsure�tat it rerrtains above�Fte finishe
grade o�F�he farttt�r property. �D��f 638,1156,1199.j .
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City of Fridley
Water De artment
Address � �
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Name G,�y l�d��,,t., �'� � , �
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Date S -+�J�, d�
Old Meter Number_� �"
Old Meter Reading 3 �-- f'�
Replacement No.� � � J� � �
Replacement Readinq �j
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Replacement Make Q
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Remarks• S7" � �( _.
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Signed