Meter Swap , ,
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.: Cily of
Fridley
Request Number: 17900
P�Iic worka Dlv�ion �
Sen�lce Recpieat
Probtem A�esa: S 1 Talm�dge Way Req�sted By:
Department: WATER Addr�:: No acldress provided
Problem/Isane: INSTALL AMR METER P�oae Nnmber: 651-500-�009
Sc�eduled Date: , 018'-03-09 Sc6�d�led 11me: 08:00:00 ;�
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ACIION NEEDED:
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CYented by: Beth Kondrick I�te Cre�ed: 2018-03-08
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StAtas: In Progress Sabmitter Haa Been r
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Date Completed: CQmpleted by: �
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City of Fridley
Water Department � (��"�71?�v�
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the C'�ty of Fridley and/w�ts employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water(ine from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City of Fridiey and/'�ts employees harmless for arry damages that may oaur while doing this
operation. This to inctude,but not limited to vahres,piping,walls,floors or the wrb stop box and servi�line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � ly �(/►' / v t/
Name: Address �I I � �1��!/��'1� ��lG
Phone Number��� � :J� �' /�� ` p�e ��9 ` � (j
�/ Signa�ure /' �/�.� WitnessSignature s
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OLD METER#_ , � I -1 � �V�(7 SIZE & STYLE(Circlel
OLD READING � lY � / �� 5/8" HEX
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NEW METER# 1 �� � � � � lS/ 1" HEX
NEW READING v I�" ELIPTICA� or HEX
ERT# �'a 3� �� � 2" ELIPTICAL or HEX
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINIS'TRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to construding or repair of arry water of sewer line connecting the existing municipal system and any house or building for which the
application Ys made,the owner or contractor shali be required to obtain a permii for such connection,and shall pay a permit fee as provided In
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notifred. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incider�t thereto has been approved by the C'ity as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the wate�senrice curb stop box or the sewer lead at the pro�rty line or a water service tead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be IiaWe for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests mainte�ance service or repairs be performed by the Ctty,the property owner shall be charged for the costs of the mair�tenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. it shall be the responsibtllty of the applicant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main induding debrts clearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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CITY OF FRIDLEY Account Number AMOUNT DUE
a� 6431 University Avenue N.E. 315-520770-03 $146.42
Fridley, MN 55432 Due Date After Due Date Pay
� � �"�`��'�� (763) 572-3529
������` www.FridleyMN.gov 3/30/2018 $161.06
Service Address
51 TALMADGE WAY NE
There wlll be a charge on all returned checks.
Please retum this portion wkh your paymeM.
When paying in pe►son,please brinp both portions of thls bill.
MAN HUYNH REMIT AND MAKE CHECKS PAYABLE T0:
51 TALMADGE WAY NE CITY OF FRIDLEY
FRIDLEY,MN 55432 6431 University Avenue N.E.
Fridley,MN 55432-4303
315520770030000000146420000000161061
CUSTOMER ACCOUNT INFORMATION -RETAIN FOR YOUR RECORDS
Name Service Address Account Number
MAN HUYNH 51 TALMADGE WAY NE 315-520770.�3
Status From e^��ce ate o #Da s Bill Date Pena{ty Date Due Date
Active 10/31/2017 1l31l2018 92 2i28/2018 3/30/2018 3/30/2018
PREVIOUS BALANCE 5583.43
PAYMENTS �0.00
ADJUSTMENTS 5583.43-
PENALTIES 50.00
CURRENT PREVIOUS PAST DUE AMOUNT S0.00
METER# DATE READING DATE READING USAGE
FIXED WATER CONS 18.00
STAT'E SERV CONN 1.54
SEWER BASE CHARGE 50.00
SEWER USAGE 59.39
STORM WATER 9.24
RECYCLING 8.20
Tax 50.00
ADJUSTED BILL $146.42
AMOUNT DUE 5146.42
AMOIJNT DUE AFTER 03/30/2018 S161.06
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