Meter Swap � Request Number: 12177
Public works Division
Service Request
Problem Address: 1561 60th Ave Requested By: Jermy w/D&D Plumbing
Department: WA1ER Address: No address provided
Problem/Issue: TURN WATER ON/OFF Phone Nutnber: 612-594-1502
Sc6edule Date: 2016-110 ,,,�J SchednledTlme: 09:00:00
�UJ �\�` �
ACTION NEEDED:Turn offwater.Leave key.Pernut#2016-02530****BILL***•
Created by: Wendy Hiatt Date Created: 2016-11-02
ACTTON TAI�N: �-� m�.��
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Status: In Progress Submitter Hss Been r
Contacted
Date Completed: Completed by:
l 1-- ��- t� _.
, City of Fridley
�ater Department
` 6431 University Avenue NE
' Fritlley MN 55432
• (7b3} 572-3561
Uwe hereby authorize the City of Fridley andlor its
employees ta do what is necessary to shut offtb.e water at the curb stop box. I understarid
that the property owner is 3iable for the water li.ne from the mai.n to the premise. (Per
City code 402A6) I also hold th.e City of Fridley andloz its emplayees harmless for auy
damages that may vccur while daing thi.s operation. Tbi.s to in.clude,l�ut nat limited to,
sod,yard,landscaping,trees, shrubs,driveways,sidewaiks or the curb stap box and
service lin.e. �understand I am also requir�d to abtain a penmit prior to any work..
Name: Address:
Phone 1�Tumber: Date: _
Sign.a.ture:
Witness Signature:
FRi�}L�Y CITY CODE
CHAP'T.FR.40�.R'ATER,STURM WATER AND SANTPARY SEWER
r�DMIlrTLSTRATION
(Ref OrdNo l I3,�64,565,566,629,638,662,922,988, 1144,1156,1141)
40�,05. PERM�f F�E .
Prior to constrnctiu�or repair of any water or sewer liue cannecting the existing municrgal system aud any
house or building for which the appfication is made,the owner ar contractor shall be xeqnired to obtain a
pesmit for such co�ection,an.d shall pay a,permit fee as provided in Chapter 11 of 1�is Code. .A#�er such
comoiection has been made,the VJater and 3�wer Depazhnent shall be nokified. It sha.11 be unlawfi3l ta cover
any conn.ecting line until an inspection has been made and such conneciion and i�e work incident thereto
has�een agproved by the City as a proper an.d s-aitable connection.
402.06. REPAIRS AND lYiA1NI'ENANCE TO CONNE�TIOI�
Aftar the initial.connection�as been made ta tb.e water service cun'b stap b�x ar the sawer lead at the
properiy line or a water service or sewer lead has been extended to the properiy]ine for cannectirna,the
applicant,owner,oz the occupant or user af such premises shall be Izable for all repairs required to anY
water line and anp sewer lines necessary far cannactian of the prsmises from t�e m�u to ttie premises. If
the property owner requests maintenance servicas or repairs be perfornied by the City,the prope�ly awner
sball be charged for the costs of the maintenance$n�/or repaixs,in.cluding any necessary street repai�s,at a
rate set annually by an a�m;nictrative policy. It shall be ifie respansibility of tt�.e applicant,qwner,occnpaut
or user ta'pearfozm standard maintenauce of the sewer service lme�Com t3�.e pre�ises to#he mau�in�cluding
debris clearing or rovt c�'�an.d to maintaan the water service curb stop box for operab�i.Y mad at sach
height as will ensute that it remains above the fm�ished grade of the land or property: (Ref 63 E,1156,I 191j
� City of Frid{ey .
- . . - NllatPr department ._. - -- - �. -
8431 Universfty Avenue NE
Fridley,ft�N 55432
(7fi3)5723586
�f we hereby authorUce���Y��dtey andjor i�s
employees ta do wh�t is necessary ta repiace the water meter.�u���and that the praperty uwner
�lfia�l�f9r the water Itne from the main to the prernise and aU interiar ptum6ing. (Pe�City cade
402.08) t.alsa fiold the City of Fridley and/its emptoyees ha� or any ama�ges a may "
while doing this operatian. 'i'his to indude,but not t�mited tv;vahres,PiPing.waf�sl�°4rs°���
stap bnx and s�rvic�a line. i understand 1 am atso required to a6t�n�Pe�rt p��'cto any wurk,if
nefie�ary.
�na4 meter reading(old meter} ���� I�O
Address: �� ` ���"= �i .
Name• .
. Date: ' (4�� -
Phone Nurnber: .
. � � ! _ ��'�-Ur�uG
5ignature:
VBitness 5ignature:
� �c��«r cmr cvoE
CHAPTER 4�Z.WAi'EN,STORM WATER,ANO SANtt'ARY SEWER
ADMlNiSTRA170N
(Ref Ord No 113,4fi4,5b5;5G6,6Z9,b38,562,922,g88,1144,1156,1191}
4flZ,05.PEfiM1T�EE �
Priar Ca constru�ting or repair of any water or sewer line connecting t�e existing municipat system and any hause
nr building for which tfie applicatinn is made,the owner ar eontractor shall be required to obtain a petrtrit for such
canrtecdan,and shall pay a permit fee as provid�d in Chapter 11 of d�is Cbde, After such connedian has been
made,the 1Alater and Sewer Department shal)be notified. It sfialf he unlawFul to tover any connecking line urrtit an
inspection has been made and such connec4on and the work inc9de�thereto has been�pp�aved by the(�ty as a
praperand suitable connectian.
402.06.iiEAAfRS AND MAINTENANCE TO CaNNECTtQM
i--�---—�,an*��r water service cur6stav hnx Qrthe sewe�lead atthe propert'�
-A�t�-ia'daa!_conneaiau�as.�
line ar a w�ter senrice or sewer lead has been extended to the properiy{ine f�r cannection,the applicar�t,owner�
ar the occupant or user af such premises shall be liabte far all�epek�required to arry water line and sewer fines
necessary fior connection o�the premises from the main to the pr�ises, tf the propecty awner reqnests
maintenance service�r repairs 6e performed by the CitY,the ProP�iy awner shafl be charged for the custs of the
. maintenance and/ar repairs, inciuding any neces�arY stceet repai�,at a cate set annuallyby.an adm4nistradve
palicy. It shali be the responsihility aft�+e�Pp��'�ant,awner,occupantDr user t4 perform standard maintenance of
• the s�wer Service tine fram the prernises ta the main incfuding de�is clearing or raot cutting and to mair�ain the
water service cur6 stop box for operability and afi such height as w�ensure tt►at it remains abave the Bnished i
. _
,,.g�,acT"e r�ft�r��tarrd arpra�rty.�jRee�fi;�,y�5,-���} _� .� . . . .._ � -