Meter Swap . ° Request Number: 13132
Public works Division
Service Request
Problem Address: 1512 S Timber Ridge Requested By: J�e Christeffion
Depsrtment: WA1ER ,�dd�.egs: 1512 S Tunber Rid�e
Fridley,MN SS432
Problem/Issue: INSTALL AMR METER Pho�Nnmber: 612-559-1310
Sc6edule e: 2017-02-09 Schednled 1lme: 02:00:00
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ACIION NEEDED:
Createdby: BethKondrick DateCre�ed: 2017-Oi-27
ACTT N TAI�N: �
Status: In Progress ���er HAs Been �,
Contacted
Date Couapleted: �.-. � -- I� Completed by:
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�vatea-�par�a�ees�t
5431 t9n6v�rsityf Aver��ae�IE
Fridley➢ lN111 55432
,. 7�3-5�'Z-356� � ( ls -" �'� � ~��L�" �-`� �
�/�"°� her�by authorize the�'rly a#Frirlley as�djvr its empioyees to s!o what is necessary to
re�lace the water rrieter. 1 understand that�he property owner is iiabie for the wafier liae from the main to the premise and all errterior
plurrabing. (Per Crty code 4U2.06� i adso hold the Cit�/of�eidley and/its empioyees haemless#or eny tlamages tfiat may occur ivhile doing this
o,�eration. This to�nclude,but not limi�ed to valves,p�ping,waits,floors or the curb sCop box and service line. in understand!am alsa requir
to obtain a perm+t prior to ar�y wor�c,if necessary. �� � �
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FtiVA1.INETER READIAIG(oid meter) �
lVame:
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Phone Number `-r �Z" 1 �g �` t��� DaCe ��� � ��
Signature �"
WFtness 5igrtature
atD��E�� ��1 ����
OLD READtt11G���a�� o
MEW METER# _��� � ��p�.,
NfW READI11iG �J
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ERIDCEY CITt(CODf
CHAPTER 402.W�1TER,STORM WA7'ER AWD SANITARY SEWER
ADMNItISTRA7'IQN
(Ref Ord No 113,464,565,�66,629,635,562,922,988,1144,i156,i191}
402.5 PERriIfiT FEE
Prior to constructing vr repair of any waier of sewer ti►ze connecpng tfie existing mu�iapal systern and arry house oc buitdi�for wFiiicd�the
a�plicatian is made,the awner or coma�actar shal!be required to abtain a perm'rt for such connection,and shaii pay a permiCfee as provided irt
Chaptec 11 oF this Code. After wch connection has been made,fihe Water and Sewer Departmertt sha11 be rto#ified. tt shall be unfawful to co�
any connecting line uMa'i an irtspection has been made and such connection and the work inciderrt thereto has been approved by the City as a
proper and sui�taabte cortnection.
402.06 REPAIRS AND MAIf�TEMAlyCE Tt?CONMECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water serviae Iead has
been extended#a the properiy line for connecCion,the apptiprrt,owner,or accupar�#or user o#wch premises st�ati be i'iable for ap repairs
required#o aay water{ine and sewer iines necessary#or con�ection of the premises from the rnain to tfie premises. if the properi.y owner
�equests maintenance seraice or repairs he performed by t�e City,the property owner shaU be d�arged fvr the costs of t!�maicrtenance andior
repairs,includir�g necessary.street repairs at a rate set annuaily by art administratide poliry. ft sfiail be the responsbit'sty of tf�applicarrt,
owner,occuparn or user to perform standard mairrtenance of the sewes service tine from tt�e premises to the main inciudi�ckbris dearing or
root sutting and to mairrtain the water service curb stop boK for operabili#y and at such height as will ensure that it remai�a6ove the finished
grade ot the la�d or property. (Ref 638,1156,1191)
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Ci'ty of Fridley
Water Department
Address �J �,c s ,'1 ����� ���q �
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Name ��. � C' �I'i.3'T tn S�� -
Date /"� � �- f �}
Old Meter Number
Old Meter Reading � � � y �(�
Replacement No. �'� � -1 g p
Replacement Readin
Replacement Make_ f.�-��-Q-r
Remarks:_ C"��-_= �)1,��'1'�
Signed
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