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City of Fridley
Water Department
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Request Number: 10180
Public Works Division
Service Request
Problem Address: 7341 Jackson St Requested By: Wendy Hanson
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-785-4904
Scheduled Date: 2015-06-16 Scheduled Time: 1 : 0:00
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ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2015-06-10
ACTION TAI�N: .
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Status: In Progress Resident Contacted p
Date Completed: Completed by:
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City of Fridley - ,
Water Depaztment
6431 University Avenue NE
' Fridley MN 55432
, . t763) 572-3561
Uwe hareby authorize the City of Fridley and/or its
employees to do wl�at is necessary to shut offthe water at the curb stop box. I understaad
that the praperty owner is liable for the water li.ne from the main.to the premise. (Per
City code 402.0� I also hold the City of Fridley and/or its employees harmless for an.y
dam.ages that may occur while doing this operation. This to include,�but not li.mited ta,
sod, yard,landscaping,trees, shrubs,driveways,sidewalks or the curb stop box an.d
service line. �understand I am alsa requi.red to obtain a pemut prior to any work.
Name: Address: I_�-! �����_
Phone Number: Date: ���� '
Signattae.
Witness Signature:
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FRIQLEY C1TY CODE
CHAPTI:Ii 402.WATE.R,STORM WATER AND SANiTARY SEWER
. ADMIlVISTRATION
(Ref OrdNo 113,464,565,566,629,638,662,422,988, 1144,.1156,1191)
4QZ.05. PERMTC F�E
Prior tfl 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 ar contractor shall be required to obtam a
pemut for such connection,and shall pay a pernut fee as provided in Chapter 11 of this Code. After such
connection has been made,the Water an.d S�wer Department shall be notified. It shall be unlawful to cuver
any connecting line until an inspection has been made and such connection aad the work incident thereto
has been aggroved by the City as a proper aud sm.table connection.
402.06. REPAiRS AND MAIlVTEN.ANCE TO CONNECTION
Aftar the initial connection has been made ta the water service curb stop box or the sewer lead at the
properiy lme or a water service or sewer lead has been extended to the property]ine for comie.etion,the
applicant,owner,or the occupant or user af such premises shall be liable for all repairs requaed to auy
water line and any sewer lines necessary for connection of the premises from the main to the premises. If
the properiy owner requests maintenan.ce services or repairs be perfoimed by the City,the property owner
shalt be charged for the costs of the maintenance and/or repairs,in.cluding any necessary street repaias,at a
rate set aw�ually by an administraiive policy. It shall be tbe responsbility of the applicant,ownet,occa�rant
or user to`perform standard maintenance of the sewer service lume fram the pre�ises to 1i�e main including
debris clPan�or root cutking and to maintain the water service c�rb stop box for operability aud at such
height as will ensute that it remains above�e finished grade of the land or properip: (Ref 638,1156,1191j