Meter Swap - �?--�1� � ��L��- ���I ti�%
'� INSTALLATION
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FRiDL�EII ;�-.,r�,�. . �.; .
Address � 1 `f b � {� �� --1 1
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Name �.J� ��: �, C������� 1 <1��
Date T �� � � �
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Old Meter Number i � �� � L.� �:� ^�
O1d Meter Reading �' �' � `�' �� `-�
Replacement Na � Q� 25 � �� � _
Replacement Reading �
Replacement Make �� q ��1 �r
Remarks: V� —[\�
M�
r �...� r.
Signed: �—f����.-•*�'��.�--
Reques# far Service Report
. • � �ity of Fridle�r
Reference No: 601-11-2$13 Date: 02I07171
Request Type= Install regular meter Enkered By: Wendy Hiatt
Deparkment: Water Citizen�lame: Da�id Greenlaw
Address= 6766 7TH ST NE Callback Phone: 651-259-7144
Scheduted Date �,�'"`��t1�':'�� �'` �' t " Property Owner.
Location Details: Home: 763•572-9743 Request Details: Change oldfhard ko read meter
Action Taken:
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o l� r�e.-{.� � 1 �I a 1 s 6 7 7
- r, �a V'edd�r.� �16 � �- $ �
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0�e`^, 1(C�-�,�n� �
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Responsible Person:
Approver.
Campletion Date: a itixen Notified
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Y
�1�' Of�II{��V
�,Tat�De�arxtr�e�t
: 5�31 tT�i.ve�si-ty Avenue l*�� ,
Fndley i��T 55��2 , �
(7��) 57?-35b1 "
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� Uwe c��v� �. �r-e�,� j r w he�e�y a�o��the �ity of�'i7dley a�.r�'/or its -
em�loye�s to �o �zl�a�is n���ssary ta r�pla�s;.�.e water meter_ I_u�.de�st�.ud thai'�i.�e
Pi'DP�Y ow�.er is liable ior the w�er line from the main to t�.e prerais� ansi�interior
�lu�nbi�a_ ('2'er�i� cade�Q2.0� I also hald t�.e C�.ty of Fridley and/or iis em�lovews _
�a�nless far any damaaes that�a�oc�u�w71ile c�ai�:b this operation. This to inciude,but
noi li�niter3.to; `ralves,piF�, wa.ils,f�ers or t�ie cu�i�sto�box and se�iice li�e_ I
�n.derstand I am aisa requi�Pd to flb-�a�n. a��,�it pror tD�n.�wori�, if�ne��ssary.
1�ame_ ���v�, � � �,'�'2rl��� :4�dress: �v ��� �`�'L_ .�f. /vC �i��l�R � !GI�1J
�`f
1 hone 1�-umber: ��3 —,5�a.-Cl '�S Date: SS S�`��"
7 �o�(O�:l - v2—d�'1
Signai�re: ^ � ,� �--
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�`nTituess Si�ature:
��i�Y�'L����i�� _ �
- �'�t���fl2.'`v�r�.�'+�,�'�'�����'i�'��8���d'.1'+T�.�.'������
' :�T�'�i �'�'�.�'�'��1�T
(kei Ordi�T-0 11�,4b�,Sb�, 56b, 629,530,6b?,9�?,938, 11�, 1150, 1191)
�az.a�. ����� ,
P�or to cons�-uciing or repair oi any wate3-or sewer line conue�img the e«isting mu�icipal system aud any
house or�uilcling for w}ucn�t�e a�p�cation is m2de,the o��r or cantractor shall be re�uiree�.io o'�caiu a
pemiit for such conneation, aud s31a11 aa�a pet�nii f�e as provideri in C'na�#e;11 of t.�is Code. After�such
cann�ctinn has been mad�,the�7at�r an�S�w�Departme�sha11 be noti�e�.. i#shall be uialawnat�Q co��er
any ccn�e�ti.u�?in�u�til an mspe�tion has be�n made aud such canne�iian and-�h�work i��ideni t��reto
�as been apprevert by�e Ciig as a pro�es-�c�s�i.�able cannertion.
�U2.fl6. ���s�I�I�/��T3�.��T�I�:��'� �����'I'��1°�
.�fte:�.he initi�l.c3naeciion h2s b�n��ie to the��r��r ser!ic� c�rb stop bon or i.he s.ewer Iead at tl�e
property�line�o�a�ate:ser�rica�r se�rer lead has bean z.>iend�tfl iha l��P�Y line fcr e�uectiox��.a '
applican� owner,or-d�e oc�upant or u.ser�f sac$�remises shall be liable far a3I repairs requirzd to anp
water lin�and any sew�r lines ae�essa�r icr cozmection Qz i�te premis�s from i`�e main tn�th�prem:ises. Lf -
t�e properiy a•+�er re;�uesrs�ain#�auce s�rv?ces or re�ags bs performed by ihe �iiy,�e proper�y owner
shall be char�ed ior�e costs oz i'he rua�te�ancti and/D�-n�a�s� inciuding any�ecessat;�stre�t repairs,at a
raie se#a-�italiy by an aami�is�razive�olicy. ?i shail re ti�e rEst�anszb�li.t��ofthe anpiic�T, otivner, o�cunant
ar us�z to pyri�zta st�dard ma:n-tz�anc�of the sewez,ervic�-�e from tha pre�ses Lfl t�.e�am inc3uciin;
de'�ris cl�a�-vig or raoi cutti���d io m�ainra�.t�e�at.�r s�rzric� curb siop b�x f�r•o�aerab�lit�aud at s�
he:ght as will ensnre it�at rt�-em�s abuve iha friis�e�.gcaae o�u-�..e laud or�ra�eriv. (R�i 634, 1?�5, 11�1 j
Req uest N u m ber: 8067
Public Works Division
Service Request
Problem Address: 6766 7th St Requested By: David Greenlaw
Department: WATER Address: No address provided
Problemllssue: INSTALLAMR METER Phone Number: 572-9743
Scheduled D te: 201406-13 � Scheduled Time: 01:30:00
c LsLJ �. �
ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 201406-12 �
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed
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• - City of Fridley
Water Department _
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
���e hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. i understand that the property owner
is liable for the water line from the main to the premise and al!interior plumbing. (Per City code
402.06) i also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,ftoors or the curb
stop box and service line. 1 understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) " "—' � � � �O
Address:�D� n 1 Q ����
Name• �
Phone Number: Date:t�� ��� I
Signature•
Witness Signature:
FRIDLEY CITY CODE
CHA ER 2.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144,1156, 1191)
40Z.05.PERMiT FEE
Prior to constructing or repair of any water or sewer line cannecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,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 shall be notified. It shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the prope[ly owner requests
maintenance service or repairs be perFormed by the City,the property owner shaH be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
° the sewer service line from the premises to the main including debris clearing or root cutting and to maintain 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)