Meter Swap Request Number: 16258
Public Works Division
Service Request
Pt e elem Address: 4540 2nd St Requested By: Greg Miller
Department: WATER Address: No address�ovided
Problem/Issue: MALF[TNCTIONING METER Phone Number: 763-439-5752
Scheduled Date: 17-07-07 „� SchedWed Tlme: 10:30:00
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ACTION NE
Created by: Wendy Hiatt Date Created: 2017-07-06
ACTION TAI�N: -
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Status: In Progress Submitter IIas Been �,
Contacted
Date Completed: Completed by:
`�-�-��
,
City of Fridfey
Water Departrnent nr r�y �,��`
6431 University Avenue NE � �a 3
Fridley,MN 55432 S Q-� ��C�
763-5723566
��We hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code�t02.06) 1 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,ffoors or the curb stop box and service line. tn undenrtand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAt METER READING o!d rrteter �'� � ������`�
i l
Name• Address���"' ����"'�
Phone Number p� !'`� ~�
Signature -� Witness Signature �
OLD METER# �` i � i�
�u� �tt.-z-#�.`� �t��`� .
QLp READING ��S � ��
�NEW METER# �-r-.�.���
µ�11t�W READlNG �
ERT#_ �� �--�, ��, ICjQ�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WQTER AND SANITARY SEWER
ADMlNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,�1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shali be required to obtain a permit for such wnnectlon,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 shatt be notified. tt shatt be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident tfiereto has been approved by the C'�ty as a
proper and suitabte connection.
402.06 REPAIRS A!1!D MAINTEIYANCE TO COM11lECTION
After the initial connection has been made to the water service wrb stop 6ox or the sewer lead at the property line or a water serotce lead has
been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shall be liabte for atl repairs
required to any water line and sewer lines necessary for connection of the prernises from the main to the premises, if the property owner
requests maintenance service or repairs de performed by the C'rty,the property owner shall be charged for the costs of the mair�tenance and/or
repairs,inciuding necessary street repairs at a rate set annuat(y by an administrative poticy. it sha11 be the responsibility of the applicarrt,
owner,occupant or user to perform standard mair�tenance of tfie sewer service line from the premises to the main induding debris clearing or
root cutcing and to maintairt 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: 6682
Public Works Division
Service Request
Problem Address: 4540 2nd St Requested By: Greg Milfer
Department: WATER Address: No address provided _
Problemllssue: INSTALL METER(WATER) Phone Number: 763-439-5752
Scheduled Date: 2013-0&13 Scheduled Time: 10:30:00
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ACTION NEEDED: Change stopped meter
Created by: Wendy Hiatt Date Created: 2013-0&12
ACTION TAKEN:
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Status: In Progress Resident Contacted �
Date Completed: Completed by:
�=,r`_�._ ,, .� ��
�
- City of Fridtey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��w� hereby authorize the City of Fridley and/ar its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior ptumbing. (Per City cade
402.Obj I also hold the City of�ridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;vafves,piping,walls,flQors oc the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter)
�,l��d_ �s��,
Name� Address•
" a�te: `t�—(3�—t"�
Phane Number•
Signature:
Witness Signature:
FRIDLEY CITY C4DE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,454,565,566,629,638,662,922,988,11�4, 1156,1191)
402A5.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 shali be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 ofthis Code. After such connection has been
made,the Vllater and Sewer Department shati be notified. It shalt be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has been app�oved by the City as a
proper and suitab{e connection.
402.Q6.REPAIRS AND MAINTENANCE TO CONNECTION
After the initlal connection has been made to the water service curb stop box or the sewer lead at the property
Iine or a water service or sewer lead has been extended to the property line for connection,the appficant,owner,
or the occupant or user of such premises shall be liable fior ail�epairs required to any water line and sewer lines
necessary far connection of the premises from the main to the premises. If the propecty owne�requests
maintenance service or repairs be performed by the City,the properly owne�shall be charge an admin strat ve�he
maintenance andJor repairs, including any necessary street repairs,at a rate set annually by.
policy. It shali be the respansibitity of the applicant,awner,occupant or user to perform standard maintenance of
• the sewer service line f�om the premises to the main including debris clearing or root cutting and to maintain the
water service curh stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j
Request Number: 11596
Public Works Division
Service Request
Problem Address: 4540 2nd St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
Scheduled Date: 2016-06-24 Scheduled 13me:
ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
�r F"�J"`C
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Status: In Progress Submitter Has Been �
Contacted
Date Completed: Completed by:
���+�
' - City of Fridi�y
- _ ... t�lai�r Departenent . _� . .� _
64�1 Univ�rsity Avenue NE
�sidtey,MN 554'�2�
(763)572-3566
IJwe bereby authQrixe d���'�91 of frid6ey andjar�ts
empluye+�s to�o what�s necessa�ta�replace the water meter, (understand that the property owner
is liable for the water line from fhe mai�to the premise and a�i��r�or plum6�. (Per City code
402.�6) i.alsa huld the C�[y nf Fridiey andJits�employees hacmless ur any amages a may�e �
wtu'le doin�this aperativn. �'his to indude,hu��tot limited tarValYes►P�P���Isr flaurs oc fihe tutb
�op box and service line. 1 understand 1 am also requiraed to ahtain a Permi�Priar to any worlc,ff
n+Ecessary,
. �ina[metsr reading(old meter} �l��� ��� ��
Name• Address•
P6o�e tUumber; Date• .
5ignatvre:
Witness 5ignaivre•
�RiDLEY CiTY Ct1DE
CFIA3'�ER 4t]Z.WATEIC,57'�ttM WATER,AfdD SANiTARY SEINER
ADMtNIS'�'RATIOH
(Ref ard No�.13,464,555;5fi6,6�9,fi38,66�,9ZZ,988,1144,1156,5191]
4U2.05.PEi�MIT FEE �
Prior to canstructing or repair af any water or sewer line connecting the existing municipal sys#em and any house
or huifding for which the appGcation is made,the awner ar cvrr�ractar shaq be required to abtain a permi�for such
conrrectianr and shal!pay a permi�fiee a5 provided in Cf�aptec 11 of d�is Cnde. Atter such canneetian f�as been
made,the Water and Sewer�epartment shail be notified. lt shaft�e un{awful�a cavec eny cannecting Gne until an
inspection has 6een made and such cannection and the wtrrk incidertk thereto has 6een approved by the City a�a
properand�uitabie�onnaction.
402,0�.R;EP�►1R5 ANtD MAIN3E1�[ANCE TQ�C47Nf�E+CTION ,
-A���I�-IR1��rnnnarittql}I��h ^��d6 to the water service Curh stoo hax nr the s�wer lead at the prapert�.
line or a water senrice or sewer lead has heen e�ended ta tt�e PropertY��ne#or cannecUonT#he applicant,�awner,
or the o�cupant nr user af sucb premi�e�shall be ltabie fflf ali repahs required ta arry waker line and sewe�fines
neces3ary for�onnectian of the premises fi'om tfie main ta the pr�nises. If the propetty nwner reques(�
rnaintenance servtce�r repairs he performed by the CstY,the Qropetty awner shall 6e charged far the casts of the
. maintenance and/ar repairs, including any neces�ary s�reet repair�at a�ate set annuaRy�y.an admiriistrative
policy. It shali be the re5pansihility ofithe aPP�icBnt,owner,occupantor user to perFarm standard maintenance of
� the seuver serrrice ltne fram the prernises to the main including de6ri5 clearing or raot cutting and to maintain the
water service curh stop 6ox far operability and afi such height as w�l ensure that it rernains abave the finished
.
::'graite of Y'r��fia�d or-�rca�tri.y,�(R�630,��55,.;�`��� _. __ _ ._._ _ . . . .. . . �