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Meter Swap � �'��� INSTALLATIO�/� I unroF AUTOMATIC METER READER FRIDLEY Address �� �� ��,�� Name ��'A���� ��C-�+� Date ��—��' 1\ Old Meter Number ��� Old Meter Reading � � (.�.' Replacement No. ���"���� Replacement Reading (� Replacement Make ����"L.. ERT# ��� �� � Replacement ERT# Remarks: ��s Signed: R�ue�# for Serv�ce Repa�rt � � �ity Qf Fndley ���: gart-�l-aias o��: ���sr�o» � T„�� r�� ay��� ���: w��� ��: w�c� r,���,r��: e�����, �� 5715 JACICSON�T NE ac�c FFxane: 763r�1-S�643 �d D�#e= 1?�'211�f11 9=Q�AM ��d • Pra�iy�er: L�ca���on i�a�s: F�equest [lietails: Ir�stalt A�MR �� Ac:ti€xi T�en: i � � �-� ,"_v�"�,� ��� � � � � � C��l���'�--�- ��p �-7 ��1 `� � ��� 2��i��- �l�� �Z�� � �� � A�� N��� -- ���� ; � � . �� �����--�5 � ��-� - �'����Q�� � � _ __-___. _ _. _ _ __. ___.� �an�le P�st�n: yl � E �� , ----------7 �v�: � Cer�pletian��e: � CaG��Nc�t�ed � �� � ��- « �. � , - City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 (763)572-3566 ��We hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. I understand that the property owner 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 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 senrice line. I understand i am also required to obtain a permit prior to any work,if necessary. � � � "� Final meter reading(old meter) � ` �� ��i Name• Address: C ��� � �E,� - Phone Number: D � �� ` "�r-- Signature: � � ��% � �-�"�`�""��„"'YC�� Witness Signature: FRIDLEY CITY C�DE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464, 565, 566,629,638, 662,922,988, 1144, 1156, 1191) 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor 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 notified. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been 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 service or sewer lead has been extended to the property line for connection,the applicant,owner, or the occupant 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 main to the premises. If the property owner requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of • the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service 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) Request Number: 9737 Public Works Division Service Request Problem Address: 5715 Jackson St Requested By: Sandi Haza Department: WATER Address: No address provided Problem/Issue: F1NAL METER READING Phone Number: ScheduledDate: 2015-02-02 � Scheduled'Iime: A , ACTION NEEDED:Final reading.Clo ing 1/30/15 T#33303204 Created by: Wendy Hiatt Date Created: 2015-01-30 ACTION TAI�N: ���,��- ae�� ..................................................................................................................................................................................................................................................................................................................................................._........._..........................._............_..._..._. ................................................................................................................................................................:........................................................................................................................................................:..__......_.........._..................._:...................................:......_ ......................................................................................................................................................................................................................................................................................................................................_.................._....._....:..___..............................._ ...........................................................................................:......................................................................................................................................................................................................................_........................................_.........�.._._..................._............._ .................................................................:........................................................................................................................................................................................__....._..............................._.._......................................_............................................._.....__....... ....................................................:..............................................................................................................................................................................................................................................................................._......_....................._...................................___... Status: Tn Progress Resident Contacted ❑ Date Completed: Completed by: ���--�� - Hiatt, Wendy From: , Hara, Sandra Sent: Friday, January 30, 2015 2:50 PM To: Hiatt, Wendy Subject: Final Reading needed Hi I need a final reading on the AMR at 5715 Jackson St NE for a closing today 1/30/15. The ERT#is 33303204. I told them we would not get a reading until Monday since they called in so late. Thanks. Have a nice weekend! Sandi Hara City of Fridley Utility Billing 763-572-3530 1