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Meter Swap , Request Number: 13004 Public Works Division Service Request Problem Address: 1 S07 S Timber Ridge Requested By: Cathy Nelson Department: WA1ER ��.�5$: 1507 S Timber Ridge Fridlcy,MN 55432 Problem/lssue: INSTALL AMR METER Phone Number: �63-372-0866 Scheduled Date: 2017-01-30 Sched�led 1ims: 01:00:0(1 m �� AC"R�N NEEDED:Install AMR Creatcd by: Beth Kon�ick thte Cre�ted: 20I7-O 1-2A ACTION TAKEN: � �� 1 _..._._.._.�.�..._�:� ....�'__. Stxtus: In Progress Snbmitter Has Been (.. Coatuted Date Completed: Compteted by: � -- � �� VT�' . �� `� Water�epartrnent C� � 6431 iDniversity Avenue AIE �� J Fridleyy MN 5�432 � 3��j s�� 753-572-3566 �j �rW� hereby autharize the�ity af Fridley andJor its employees to aio wfiat is necessary to ' repiace the water sneter. !understand that the property owner 6s liable for the water line#rom the main to the premise and ail interior plurrebing. (Per City cosle 402.06j i also hold the C'rty of Fridley andrts employees harmtess#or any slamages that may occur while doing this operation. This#o include,but not Bimi#ed to valves,piping,waUs,tloors or the surb stop box�nd service tine. in understand i am also require� to obtain a permit prior ta any�ror�c,if necessary. FIfVAL METER READIN6(oid mefier) � �� I��.J Name: Address t y� � Phone Number � i p� '��' � �gnature Witness Signature "" \ OLD METER# �� O� �Z� OLD READING O �� ,� y��n�2�� I� RIEW METER# �j��r� _ NEW READtNG� � ERT#�� "�,G�,� f FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AWD SANlTARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,529,638,662,922,988,1144,I156,1191j 402.5 PERMIT FEE Prior to construrting or repair of any water af sewer line connecting the existing municipal system and arry house or buildirig for which the applicatian is made,fihe owner or coMractor shail be required to obtain a permit for such cormection,and shap pay a pertnit fee as provided irr Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmeri#sha(i be notifted. it shatl be unta�aful to cover any connecting Ifne urrtil an inspection has been made and such connection and the work inciderrt thereto has been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAIAITEt11ANCE TO CONNECTION After the initial connection has been made to the water service arb stop box or the sewer lead at the property iine or a water service lead has been extended to the property line for connection,the appiiprrt,owner,or accuparrt or user of sud�premkses sFiaii be liable for afl repairs required to any water line and sewer lines necessary for connedion of the premises from the matn to the premises. if tl�e property owner requests mairrtenance service or repairs be performed by the City,tfie property owner shail be cha►ged for the eosts of the maiertenance and/or repairs,Fncluding r�ecessary street repairs at a rate set annuafly by an adminimati�e poiicy. R shatl be the res�onsibility of the applFprrt, owner,occupant or user to perform standard maintenance af the sewer service line from the premises to the main ir�luding debris dearing or root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade af the land or property. (Ref 638,1156,1191) . - *� � �--� — ---�,----�—�- �� :,, Q�� , ` �� 7�J3�5 " City of Fridley Water Department Address 15d7 5 � � "v�r'�'s�-IZ'�vc Name \.,n '"'� ��Z-JJIJ Date �� C.�" V 1 Old Meter Number �C�� %� Old Meter Reading 0�� , , Replacement No. �J J ��a� Replacement Reading � Replacement Make �#�� Remarks: 5�1'�t"� .M��'`�- S igned ��v�"1-�'� �; �4 �