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Request Number: ll513
Public Works Division
Service Request
Problem Address: 5209 Taylor St Requested By: Abdo Hitti
Department: `-.4 WATER Address: No address provided
;�r Problem/Issue: i�, 1URN WATER ON/OFF Phone Number: 763-486-2377
Scheduled Date: 2016-06-06 Scheduled Time: 11:00:00
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ACTTON NEEDED:Turn off water for repair and also install AMR.****BILL****
Created by: Wendy Hiatt Date Created: 2016-06-02
ACTION TAI�N:
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Status: In Progress Resident Contacted C�'
Date Completed: Completed by:
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. � City of Fridley
�ater Department
6431 University Avenue NE
Fridley MN 55432
• (763) 572-3561
Uwe hereby authozize the City of Fridley and/or its
employees to do what is necessary to shut off tb.e water at the curb stop box. I un.derstaad
that the property owner is liable for the water line from the main to the premise. (Per
City code 402.0� I also hold the City of Fridley and/or its employees harmless for any
damages that may occur while doing tbis operation. This to include,but not li.mited to,
soci, yard,landscaping,trees, shrubs, driveways,sidewalks or the curb stop box and
service line. i un.derstand I am also required to abtain a pexmit prior to any work.
Nam.e: Address: �� d' t l��i.��
Phone Number: Date: �`E�� �
.��
, �,.
Signa
Wilness Signature:
�RIDLEY CTTY CODE
CHAPTER 402.WATER,STORM WATER AND SANTTARY SEWER
ADIVIINISTRATION
(Ref QrdNo 113,464,565,566,629,638,662,922,988, 1144,1156,1191}
402.05. PEI2MLT FTE .
Prior to constructia�or repair of any water ar sewer line connecting the existing municipal system and any
house or building for which the application is made,the own.ar or cantractor shall be required to obtam a
pemut for such coffiectio�,and shalt pay a.permit fee as provided in Chapter 11 of this Code. After such
connection has been made,the Water and Sewer Deparlment sball be norified. It shall be�mlawfut to cover
any cannectin.g line until an inspection has been made and such conuection and the wark incident theretn
has been aggroved by the City as a proper and srritable connection.
402.06. REPA]RS AND MAINTENANCE TO CONNECTION
Aftar the iuitial connection has been made to tb.e water service curb stop box or the sewer lead at the
property line or a water service or sewer lead has bean extended to the properry]ine for ccmnection,the "
agplicaat,owner,or the occupant or user of such premises shall be liable for all repairs required tfl anY
water line and anp sewer lines necessary for conneciion of the premises from the main to the premises. If
the property owner requests maintenance services or repairs be performed by the City,the p er
shall be eharged for the costs of the maintenauce�nd/or repairs,including any necessary street rep „ � a �
rate set ann.ually by an adm�ri��tive policy. It shall be the responsbility of ttie applicant,own.er,o� � *LL,
. or user to`perform standard.maintenance of the sewer service line�r+am the pr�mises to the main in.. '..�_
debris clearing ox root cutting and to ma.in.tain the water service c�b stop box for operab�lity and at such
height as will e�smme tha.t it remai�s abovie the fiIIished grade of the land or properiy. (Ref b3 5,1156,1191j
- City uf Fridiey
- . . -- U�la#pr Department ... . .� . .�_-
6431 University Auanue NE
Fridley,MN 55432
(763)572-3566
1(we 6ereby authQrize d��t'Y 4f fridley andjar its
employees ta do what is necessary tu replace the watar nteter, (understand that the prop�rly uwner
is liable far the water line from tf�e main to the premise and a6 ir�r�Qr plurobir�. (Fer CiW code
A02.Q6) t.atsa h�fd tfie City of Fridtey andJ'�ts emptoyees fiarmlessfar any amages may� "
white doing this operadon. This ta include+but not limi#ad to;vahres►P�P���•��+�OQrs or the curb
stop batc and service line. 1 understand 1 am aiso requ➢r+ed to a���P+��rt P�or ta any wurk,i�
nece�sary. �
�inai meter reading(old meter� �� � .
Name: � � �/ ��� Address: t��_,��l��
Phone Num6er; e; r —' .
Signa#ure;
Wibn�ss 5gnature;
FlttaLEY CITY CQDE
CHI�P'TER 40Z.WATEH,STORM WATF.t�,ANO�4f11lTARY SEWER
A�MINISfRATIQN
(Ref Ord Na 113,464,565;56fi,6Z9,538,662,922,988,1144,1156,1191j
4i�Z.05.FERMIT FEE �
Psior to constcucting or repair of any water or sewer line cnnnectingtf+e existing muaicipal system and any house
ar building for which the application is made,the awner or cnritrac�r shall be required ta obtain a permit for such
canrrectian,and shall pay a perms�fee as pruvided in Chapter 11 of this Cade. After such cannec�ion has heen
made,th�iNater and Sewer Department sha11 be nnt'rfied. it shall 6e unlawfui ta cave�any connecting fine until an
inspection has tseen rnade and su�h connecCion and the work incide�thereta has 6een app�oved by the t�ty as a
properand su'rtable connectfan.
40��A6.REPAIRS AND MAtNTENANCP T��0(�NECTIOW
����q��������,o�n marie ta the water service curh ston bax or the sewer(ead at the propert'�
line or a water service or sewer lead has been extended ta the propertyline#or cannectionr the appiica�rt,awn�r,
or the occupant or user afi such premise�shail be lia�ble far all�epeirs required to any waker line and sewer line�
ne�essary for cnnnectian of the premises from the main ta the premises, ifi the propetky awner requests
maintenance s�n+ice or repairs he performed by the Crty,the ProPertY owner shall be cha�ged for the costs of the
. maintenance and/ar repairs, inc(uding any necessary street repairs,at a rate set annually by.an administra�++e
poticy. !t sha41 bethe respansihility afthe applicantt 4wner,occupantor userta perfornt standard maintenartce af
� Che sewer service line fram the premises to the main including de6r�clearing ar roat cutting and to main�airi the
water servic�curh stop box for operability and at such height as wi�ensure that it remains abnve ihe finished ,
, .
- -- . ._.
.,,gracte of t���fand or-prtip�i�y,�(R�635,�,���,_:��9�:� _. _ . . . .._ .