Meter Swap .
Request Number: 10849 ,
Public Works Division
� Service Request
s,�, Problem A�ddress: 1629 N Brenner Pass Requested By: Jaclde Hazris
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-571-5977
Scheduled Date: 2015-11-17 -y� Scheduled 1�me: 02:00:00
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ACTION NEEDED:Install AMR
Created by: Julie Horak Date Created: 2015-11-16
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ACTION TAI�N: ,
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Status: In Progress Resident Contacted Cl
Date Completed: Completed by:
��-��'I S �� �(.�»�e
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- City of Fridtey
- Watpr Q�partment
6431 University Avenue NE
Fridley.MN 55432
(763)57Z 3566
f/we hercby author{ze il��af kidiey and/or its
empfoyees ta do what i�necessary ta replace�e water metet,t��nd that the propertll own�'
ter tine from i�e main to the premise and a0 iM�r�ar plumbing. (Per Citif code _
q02.�� i also huld the qtyof Fridie�andrts emplo�ee�harmless °r a°y maBes �
while doing this operation. This i�inrJude,but not limited to;��►P��B.��►flaurs nr tf�cufi
stop bax and service line. I understand i am aLo required to abt��P�"�P�°r t°a°y work,if
nece�ary.
fina{meter reading{ofd meter} • . . �
N�, Address: - :
PhoneNum6er• ___Date: .
Signature. .
iNifiess 5ignature:
� FRIDLEY�(1(CODE �
CHRPT��t��Z.WATER,STdRM WATEtt,ANO SANITARII 5E1N�R
ADMINISTRATION
(Ref Ord Na 113,454,565;566,6Z9�638!662,422,988,1144,1156,1191j
40Z.05.PERMiT FEE • �
Prior to consiructing or repalr of any water or sewer IiaQ��n���at°be requ red to btain permit for suc�
ur burlding for whid�the applicat�on i�made,the owner flr cnn
wnttection,and sh�lf pay a permit fee as Pravided iri CftaPte�u°fitl�is Code. After such cannecti�an has been
made,the i�fater and Sewer Department Q��on and the work ndd utheret i has been appronved bV the City as an .
lnspec�on has 6een made and such cann
proper and swtable connection•
aat.os.a��Rs anto nn�����'o caNNt�cn�N �
se 'ce cu�h sto hax nr the sewer lead at the pmpert"�
�e-7� fica o�un�,
line ar a water se�vice or sewer iead has s�11�labfe for a�l rePa�s�equired ta anY waCer li�ne and sewer�nes
or the occupant or user of such premises
necessary for c�nnection of the premfs ���th�C�r the P op�ty awnfec sha�be�a�ged fo the�of tfie
maintenance service�r repairs be perf
, maintenance and/ar repairs, induding�ae ane��t aWn�t O�aQ���usex tu p�fortn��n�rd maint�nance af
poticy. !t shall be the responsihil�ty of Pp
• the sewer senrice line from the premises to th�ea 5ud�he�g�����at�°Qm�°�°Y th�nis�hi� e :
wat¢r 5erv�cc��carh stap boxfor operabilrtqy an _ . _ ,. . : .:.., ._..
_ . . . . . , ...
Ref 639,�,#56;1�q�:) .._ ._._. .._ .... ..._ ....._. . . . . _. .
.,.graife df�i�tar►d orpr�p�'ty.-(