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Meter Swap Request Number: 12489 P'ablic works Division Service Request Probiem Address: 7522 Tempo Terr Requested By: Diane Department: WATER Addresa: No address provided Problem/Issue: INSTALL AMR ME1F�i Phone Number: 763-784-1434 Scheduled Dxte: 2016-12-2? Schedule�'Rme: 09:00:00 � V� c c�-^1� cZ`_ �.. ACIION NEEDED: Cre�ed by: Wendy Hiatt Dste Created: 2016-12-16 A+CIION TAKEN: ��4�'��- �-f�.-- .�.__ ,,� Status: In Progress sabmitter Iine Bcen r Co�tacted Date Compieted: "��f � �---t{.j, Compieted by:f, 7 N� —. ` City of Fridley 3 jJ,�'' ��j �� - (�l , Water Department 6431 University Avenue PIE Fridiey,MN 55432 -~� 763-572-3566 �� IJwe hereby authorize the City of Fridiey andjor its employees to do what is necessary to replace the water meter. I understand that the property owner is tiable for the water fine from the main to the premise and a{I irrterior plumbing. (Per City code 402.06) 1 also hold the C'ity of Fridley and/its employees harmless for any damages that may accur while doing this operation. This to include,6ut not limited to vafves,piping,walls,floors or the cur6 stop box and service line. In understand 1 am also reguired to obtain a perr►iit prior to arty work,if necessary. FiNAL METER READtPIG(old meter) �✓� �� { � " Name:�l 1 Ci+h.''� Address ��'r ��vK�G' '"�"�V�- Phone Num r ��'�✓ � / � � � Date ��7� �� Si nature "^�' g Witness Signature OLD METER#_- 7�� 1 �� l OLD READtING �� t 1 � NEW METER# � �� I �WJ il� NEW REAOtNCa � ERT#_�fJ t�� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANI7ARY SEWER ADMINlSTRATION (Ref Ord No 113,464,565,566,629,638,662,92Z,988,1144,1156,1191j 402.5 PERMIT FEE Prior to constructing or repair of any water of sewe�line connecting the e�cisting mueicipal system and any house or buiWing for which the application is made,the owner or wntrattor shaii be required to obtain a permit for such mnnection,and sha{i pay a permit fee as provfded in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shati be unlawfui to cover any connecting line untii an inspection has been made and such connection and the wo�ic incident thereto has beee approved by the City as a proper and witable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial cannedion has been made to the water service curb stop bax or the sewer lead at the property tine or a water ssnrice lead fias ' been extended to the property line for coanection,the applicaM,owner,or occupar�t or user of such premises shalt be tiab4e for ail repain required to any water line and sewer iines necessary for constedion of the premises from the main to the premises. ff the property owaer requests maIrrtenance service or repairs be performed by the City,the praperty owner shall be charged for the costs of the maintenance andJor repairs,inc{uding necessary street repairs at a rate sst annuaHy by a�administrative poliry. it shaii be the responsibility of the applicant, owner,occupant or user to perform standard mair�tenance of the sewer service line from the premisss to the main inctuding debris ciearing or raot cutttng and to maintain the water service curb stop boz for operability and at such height as will ensure that it remains abave the finished grade of the land w property. (Ref 638,1156,1191) � _ i !� �� w r �� _ � 7 �e ? "r �' ' `F.' �� f` � � � *��{ r �.�, �V�� . M� City of Fridiey water Department Address ��oZ� ��y►�� /t�Y^/^, Name �� C7 VC�. q Date �— D '`o � Old Meter Number �� $ 3 Old Meter Reading � j o v�� Replacement No._� � �� 3 � b � Replacement Reading � Replacement Make �� _ _ Remarks: ,S'�� Signed_ _ _ �