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Meter Swap . � ' Request Number: 12681 rubn�works I�vision Service Request Problem Address: 7565 University A� Requeated By: Jim Price Department: WATER Address: 7565 Um�rsity A� . Fridley,MN SS432 ProW em/Isaue: INSTALL AMR METER Pho�Number: 763-792-9731 Sc6eduled Date: 2017-01-12 Schednled 11me: 09:00:00 J� �� ACIION NEEDED:Install AMR .r ,�• Created by: ,, Beth Ko�rick Date Created: 2016-12-30 ACTION TAKI:N: � �in�c�� -� .� �� __._��_ __ ______. . ___. ;, . _...__.____________ _ _.�_ Status: In Progress Submitter Ha�Beea r, Contscted DateCom�eted; � _ ''Z_ t"� Completedby: Hours ��., - � City of Fridley Water Department � (`� I q � � 6431 UniversityAvenue NE v � � ' Fridley, MN 55432 � 763-572-3566 �� '�� /We hereby authorize the City of Fridley and/or its employees to do what is necessary to repface the water meter. I understand that the property owner is liable for the water line from the main to the premise and all iMerior plumbing. (Per City code 402.06) I aiso hold the City of Fridley 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. FINAL METER READING(old meter) � � �� v v V Name: �1'�1+v�. ��s`(. Address l ✓ lJ� �/`�4 V�� - � q �--`z �l 7 Phone Nusnber � �� — ( p� 1 Signature Witness Signature "��' � OLD METER# �� C� � � �✓ 1 OLD READtNG � � v ! J � G NEW METER#_ � L� I �J �� NEW READING v ERT# �� FRIDLEY CITY CODE " CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (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 connecting the existing munictpal system and amy haiise or building for which the application is made,the owner or writrador shall be required to obtain a permit 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 Department shall be n�ed. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the woric inciderrt thereto has bee�approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water sen�ice lead h� been extended to the property line for connection,the applicarrt,owner,or accupant or user of such premises shall be liable for all repairs required to any water line and sewer lines necessary for connection of the premises from the matn to the premises. If the property a�vner requests mai�tenance service or repairs be performed by the City,the property owner shail be charged for the costs of the maiMenance andJor repairs,including necessary street repairs at a rate set annually by an administrative policy. k shali 1�the responsbility of the applicaM, owner,occupant or user to perForm standard mair�tenance of the sewer service line from the premises to the main lnduding debris dearing or root cutting and to mairrtain the water service curb stop box for operability and at such height as wili ensure that it remairis above the finished grade of the land or p�operty. (Ref 638,1156,1191) � F.�,« �` `� � � � { � .�a .�. ' �l'x' 7 4.k� � �,- t ,,� 5 �. � � c city of Frialey ga �r �euartment Address �S'-�� "��`v��S�'��_ Name � �i'i l'� Date ,� l��s � Old Meter Number � — Old Meter Readin � �� Replacement No. �.�.5'�� y - Replacement Reading4��8 - Replacement Make �cr�'y�`' Remarks: � � ' �� S igned `��r ��