Meter Swap . Request Number: 13029
Public Works Division
� Service Request
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Problem Address: �i�2'S Timber Ridge Requested By: Meredith Hesse
Department: WATER ��.eSs; 1524 S Timbcr Rid�ee
Fridley,MN 55433
Problem/Isaue: INSTALL AMR METER Phone Number: 612-386-6?43
Schedaled Date: 2017-01-26 Scheduled Tlme: 01:30:00
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ACIION NEEDED:AMR
Created by: Beth Kondrick Date Crerted: 2017-01-23
. ACIION TAI�N:
` �-�-5�.�(�c� ��,�_
Status: In Progress �bmitter Has Been r,
Contacted
Date Completed: ���� r � Coa�pleted by
�' ��..�
Wa�ea-�e�artrnent � � v� � � �
�431 llniversity Avenue 6YE
Fridley, MN 55432 �j l(�-��1�c� ���--
763-!572-3566
9/we her�by authoeize the City a#Psid4ey and/or its empioyees to do what is necessary to
replace the water rrieter. !understand that the property owner as liable for the�nrater line from the main to the premise and all irrcerior
p{umbing. (Per C'rty sode 402.06) i also hoid the�ty arf Fridley and/'rts employees harmless fior any damages that may occur while doing this
operation. This#o tnclude,but not Bimi#ed to valves,piping,wails,tloors or the surb stop box and service 1ine. I�understand!am also requlre�
to obtain a permit preor to any worsc,if necessary.
FINAL METER READING�otd mefier) �� V1��� �
fllame: '"6'�if'�C o �v1 �'�,�j�' Address ���� �' J �Wu��i� �`�"1V
Phone Number l Q Y�''��3�Q'1 Lf4!—�� Date_�'� o�-Ue'���
Signature Witness Signature
OtD METER# �(Q���(
1
OLD READING__ ��, �Q"� p�Z �D
AIEW METER#� ( � � � �1 � �
NEW REA0111lG �
ERT# �.fJ Q8 i { �q
FRIDLEY CITY CODE
CHAPTER 4QZ.WATER,STORM WATER AND SANITARY SEWER
ADMIIYIS7RATION
(Ref Ord No 113,464,565,566,629,638,562,922,988,1144,1156,i191j
402.5 PEttMtT FEE
Prior to constructing or repair of any�vater of sewer line connecting the existing municipat system and arry house oc buiiding for wti�ch the
application is made,the owner or corrtractor shall be required to obtain a permit for suc(�connection,and sE►all pay a pess�snnit fee as provided in�
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. K shail be un[awful to cover
any connecting fine until an inspection has been made and such connection and the work inaderrt thereto has been appro�ed by the Ciry as a
proper and suitabte connectian,
402.06 REPAIRS ANR MAINTENANCE TO COIMMECTION
After the in'rtial connectiort has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been exfiended to the property line fior connection,the appiicant,owner,or accuparrt or user of such premfses shail be IiaMe for all repairs
required to any virater{iae and sewer tines necessary for connection of the premises from the main to the premises. if the property orrner
requests main#enance seroice or repairs be performed by the City,the property owner shail be charged for#he costs of the mairrtenan�2 and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative poliry. It shatt be the responsibility of the applicarrt,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root tutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the fi�ished
grade of the land or property. �Ref 638,1156,1191)
`��:
03'i �
��lk�S�-�at�g �
City of Fridley
Water Det�artment
Addres s � �p�,�`� S . 4 Un•�.2-��Gts
Name �L�� U..E ��LL
Date �'"�""�-Q
Old Meter Number �/�7Q�g�
Old Meter Reading y l��
Replacement No. ��j�� ���
Replacement Reading � __
Replacement Make��C�
Remarks• "1��pQ�'� ��,'T�2.
Signed �
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