Meter Swap �
�. Request Number: 12750
Public works Division
Service Request
ProMem Address: 7531 Tempo Terr Requested By: Victoria
Dep�tmcet: WA'lER ��.eS$; 7531 Tempo Ten
„� Fricticy,MN 5543?
Problem/Is:ee: INSTALL AMR METER Phone Number: 763-443-5893
Schedaled Date: 2017-01-12 Scheduled T1rne: 01:30:OQ
�%`� �
ACIION NEEDED:Install AMR
�
�
Crwrted by: Beth Ko�-ick Date Created: 2017-01-05 "
ACTION TAI�N:
������ ���
ststos: In Progcesa sa�mitter Has Beee �,
Coutacted
Date Gompleted: � — �2� �� Completed by:
,. _...._.
�
�'' _..W—�
-�'' _�-�i, -
�
�o�or rr�aoey
]A/ater Department
6431 University Avenue N� 5 O � ���
Fridley,MN 55432 ,���� ��
+ T63-572-3565 � (S`'-�
1/we, hereby authorize the Ciiy af Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liabie for the water line from the main to the premise and all isrterior
plumbing. �Per Crty code 402.06j i also hold the City e�f Fridley andrts employees harmiess for any damages that may occur white doing this
operation. This to incfude,but not limited to valves,piping,walts,floors or xhe curb stop box and service line. In understand 1 am also requlred
to obtain a permit prior to any work,1f aecessary.
FINAL METER READIPiG(aid meter) �� � ��� �v
Name• ��L���.. Address /��� 1 ��.�v J'�•�
Phone Num r � � -6'"e � ��-l3 pate �--' �d•" ��
i
„/ Si natus�e • .'"-'----��
y__
g a Witness Signature
OLDMETER# ��������
OLD READING _�� � J � ��
NEW METER# ��L�I�� � I
NEW READfNG �
ERT# �� v� �a•�� .
FRfDLEY CITIf CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER .
ADMtNISTRATION
(Ref Ord No 113,464,565,566,629;638,662,922,988,1144.,1156,1191)
402.5 PERMfT FEE
Prior to constructing or repair of any water af sewer line connecting the existing muniapai system and arry house or 6ullding for which the
appiication is made,the owner or cor�tractor shail be required to obtain a permit for such connedion.and shali pay a permitfee as ps�avided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shal!be not�ed. tt shafl be uniawfui to co�r
any conneding line u�til an inspectioa has been made and such connection and the work incident thereto has been appr�oMed by tbe City as a
proper and suitable connectian.
402.06 REPAIRS AND MAINTENAf110E TO CCINIVEC170N
After the initial tonnection has been made to the water service curb stop box or the sewer fead at the propert�/iine or a water servke lead has
been extended to the property line for connection,the appticarrt,owner,or accupant or usec of wch premises shatl be lial�e for afi repain
required to any water line and sewer lines necessary for co�ned+on of the premises from the main to the premises. ff the property orvner
requests main#enance ser+rice o�repairs be performed by the C'rty,the property owner shail be charged for the costs of the mairrtenance andJor
repairs,includi�g necessary street repairs at a rate set annually by an administrative poliry. It shatl be ifie responsibiltty of the appGcant,
owner,occuparn or user to perform standard mairitenance of the sewer service line from the premises to the mairt irscluding debris dearing or
root cutting and to mairrtain the water service curb stop boK for operabit+ty and at such height as wiit ensure that lt remains above the finished
grade of the land or p�aperty. (Ref 638,1156,1191)
.. L
. D �. � �i� � �
��,��!%, f �,�m p t
��r t �; 'S;� � � ' if�•� � "'� r r� bxFF� .
. ��Y� A �Y.`�i ,�.�i��„
Gity of Bridley
Aater Detiartment
Address�5�,f �,,�Ni�'�'r"�,��
Name �,..�� ,C��,SSn�
Date_ ���c(��
Old Meter Number �
Old Meter Reading �
Replacement No. 31������'ja
Replacement Reading �
Replacement Make �'j��
Remarks• �r
Signed �
����