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Meter Swap Request Number: 12565 Public Works Division Service Request Problem Address: 7430 Tempo Terr Requested By: Deborah Rocken�ch Department: WATER Address: 7430 Tempo Ten Fridley,hIN 55432 ProW emlIssue: INSTALL AMR METER Phone Number: 763-442-5010 Sc6eduled Date: 2017-01-09 Scheduled 15me: 10:30:00 6 �'I �� . ACTION NEEDED:Install AMR Created by: Beth Kondrick Date Created: 2016-12-23 _*.r ACITON TAI�N: ��_��.�.... . �-...____...................._�..._.....:..:...___�.-_....__.._._._......__..............___.........................__._.._._..__.............w___........._..._.__._�_..____�__. ......................... -��..... Status: In Progress Submitter Has Been �, Contacted Date Completed: Completed by: ��`�r-_""y�"� J - �(�- l � , � City of Fridley �� G' � " �� Water Department 6431 University Avenue NE � 1 � ��/ Fridley,MN 55432 � � � 763-572-3566 I/we here�by authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. 1 understand that the property owrler is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06� I also hold the City of Fridle,y and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand I am also required to obtain a permit prior to any work,if necessary. � i� FINAL METER READfNG(old meter) � �� Name: �J��i�. �—P."-� Addr s L i � V ��2 � ��1 ' Phone Num �� '" Date � � t � �Signature " Witness Signature ----�-�� OLD METER# ��0�� S OLD READING ��--�� NEW METER# `7� I� �� NEW READING � ERT# d�C��J(/� �l � FRI LEY CITY CODE CHAPTER 402.WATER, RM WATER ANO SANtiTARY SEWER AD INISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecti g the existing municipai system and any house or building for which the application is made,the owner or contractor shali be�equired to btain a permit for such connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,th Water and Sewer Department shall be notified. It shali be unlawful to wver any connecting line until an inspection has been made and such co}�nection and the work incident thereto has been approved by tfie City as a proper and suitable connection. 4fl2.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water senrice cur stop box or the sewer lead at the property line or a water service{ead fias been extended to the property line for connection,the applicant, ner,or otcupant or user of wch premises shall be liable fo�ali repairs required to any water line and sewer lines necessary for connectio of the premises from the main to the premises. if the property owner requests maintenance service or repairs be performed by the City,t e property owner shait be charged for the costs af the maintenance and/or repairs,including necessary street repairs at a rate set annually by n administrative poliry. It shall be the responsibility of tfie applicaM, owner,occupant or user to perForm standard maintenance of the s er service line from the premises to the main including debris dearing or root cutting and to maintain the water service curb stop box for o ability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) ' .�� ,.. ✓� � �� /��`��` �",� `,� city of Fridley ��'°°�' Water Denartment Address__ � �� fG, J�� 7 Name S�� . Date� /�� Old Meter Number '--� �S Co�gU7� �- 0� Old Meter Reading� �. 3- ' �___r �,. Replacement No.� ;A zf�-�S---� ` Replacement Reading �j Replacement Make r�a�.�Cgc,.�.-- Rema rks:_�rr� ��,��' Z�� ''!�C /�711.1.��7� �Signed � ' r •� i