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�,ddress �����
Name ���'�s ��
Date �I��� `�!l9
Old Meter Number � � �c�.��
oid Meter Reading �
Replacement No: ������ ��
Replacement Reading �
Replacement Make ��
Remarks• �►.� ��'�E�
S igned f"�
Request Number: 11839
Public Works Division
Service Request
Problem Address: 7376 Stinson Blvd Reqeested By: Brenda Roame
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-978-5050
Scheduled Date: 2016-08-11 � Scheduled'Iime: 01:00:00
_ us�t- t 1�`' � I: o0
ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2016-08-09
ACTION TAI�N:
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......................................................................................................................................................................................................................:................................................................................................................_._._............_._....................._.....................
Status: 1n Progress Submitter Has Been �
Contacted .
Date Compieted: Completed by:
� ���^�� ���
Hiatt, Wendy
Subject: Brenda Roame, ph#612-978-5050, AMR Install
Location: 7376 Stinson Blvd NE
Start: Thu 8/11/2016 1:00 PM
End: Thu 8/11/20161:30 PM
Show Time As: Tentative
Recurrence: (none)
Meeting Status: Not yet responded
Organizer: Johnson, Susan E.
Required Attendees: Hiatt, Wendy
1
,
- City nf Fridley
- . ._ -..., U�la#er Dppartme�t
.... .
6431 University Avenue NE
Frodlep,MN 55432
(753)572-3566
i/.we hereby autharize the Gity af fridiey and/or it�
emp{oyees to do what i�necessary tu replace the water meter. �ur����+d tha�t the property owner
is tia�le far e water line from the main tn the premise and atl i������P��mb��• {Fer City code
402.Q�) I.alsa hald the City of 6cidtey andf its emptoyees harmless �r any amages a tr�y Qc
while doing this operation. This to indude,but not timited to;ualues,piping,�Is,ftaors or tfie curb
stap bnx and service line, 1 under�tand t am also requir+Ed to ohfi�n a Permit Prior tv any wosk,if
nesessary,
. Fina[m�ter reading(o!d meter) 3 � .
Name: Address: .
Phone Number: �e'
Signaivre:
Witaess 5ignature; �
�FRIDLEY CiTY CODE
�H�f'TER 402.WAl'ER,51't7RM WATE�,ANO�ANiTAFtY SEWER
ADMINISTRATtUH
(Ref Ord�la 113,464,565;5fi6,�29,638,562,922,988,1�.Ar1,1156��191j
4t��.05.PERMiT FEE �
Prinr to canstructing ar repair nf any watQr nr sewer tine connectingthe e�cisting municipa(system arrd any house
ar huilding fQ�which the appfication is made,the owner or corrh-actar shall be re�Uired to obfiain a pe[mi�for such
conrrectian,and sha11 pay a permiiG fee a5 pravided in Cfiapter 11 of this Cbde. After suc6 cannectian has been
made,the`Water and Sewer Department�hall 6e notifted, it sha((6e unfaw[ul ta caver any connecting line unfil an
lnspection has 6een made and such cannecCion and the work incident thereto has heen approved by ifie City as a
praperand su�table connectian.
402.06.1iEPAiRS AND MAINTENANCE TO tONIVECTIDP+I
-A#�b�-iai�ia,���np�*�n�has h�n r�acie�r *he water service curb stop bax nr the sewer lead at the propert�
fine or a water service nr sewer{ead has beeri extended to the proper[y l;ne#ar cannectton,the appl�cant�owner,
o�the occupant or user afi such prem�ses shali he liable for all�epalrs required tri arry water line and sewer fines
neces5ary fot connectian af the premises from the main#a the premises, if i�he properly owner�equests
mainfienance service or repairs he performed hy tl�►e Ctty,fihe P+'aPe�.Y awner shall be cha�ged fnr the cflsts af the
. maintenance and/or repairs, inciuding anY neces�aN�reet repairs,at a rate set annual[y by.an admin�strative
pofi�cy. it sha!!be the respons�bil+tY ofthe applicatit,owner,occupant or user in perForm standard maintenance of
• the sewer service line fram the prem+se$t°the main inctuding dehris�learing or r��t cutting and t�mairitalri the
water servic�curh stnp box far ap�rabifity and afi such heigfit as w+N ensure that it rernains abave the finished_ ._ . - ..
<:'�,aife of tii�tarsd ar�r���i.y.-{R�+63�5,y�5,.?���:� _� ._. _ ..._ ._. -. .. _ _..._ . ... . .._. _:..� :_..