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Addre�= �1�TH A'11E� �P�: 'J63 571-��4�
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Request Number: 7982
Public Works Division
Service Request
Probkm P�ldress: 371 66th Av�e Requested By: Mike Lee
Department: WATER Address: No address provided
Problem/Issue: INSTALLAMR METER Phone Number: 571-3741
Scheduled Date: �Sc�h�eduled Time: 07:00:00
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ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 201406-04
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Complete y:
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. City of Fridley
Water Department
6431 University Avenue NE
� Fridley,MN 55432
(763�572-3566
I/we hereby awthor'sze the�ty of Fridley and/or its oWner
employees to do what is necessary to replace the water meter. f understand that the p�operly
is{iab{e far the water line frorn the main to the premise and all interioan��amjages hat may oaur
402A6) I aiso hoid the City af Fridley and/its ernp�oYees harm�ess for `Y`n ���5'���or the curb
while doing this operetion. This ta inciude,6ut not limited ta;valves,p p g� .
stop box and service line. i understand I am also required to obtain a permit pr+or to any wark,if
netessary.
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Final meter reading(old meter)
Name• Address`
Phone Number•
Date• `�'� v' �
Stgnature: �
Witness Signature:
FRIDLEY CITY CODE
CHAFTER 402.WATER,STORM WATER,AND SAMITAFtY SEWER
ADMINISCRA710N
(Ref Ord No 113,4G�,565,566,629,638,662,922,988,1144,1156,1191)
402.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line cannecting the existing municipai system and any house .
or buiiding for which the application is made,the owner or contsactor shal!6e required to obtain a permit for such
connection,and shail pay a permit fee as provided in Chap ft shafl behunlawful to cover any c nneicti g(ineeuntil an
made,the Water and Sewer Department shall be notiPied roved by the C�tY as a
inspection has h�en made and such connection and the work incident thereto has been app
proper and suitabfe connection. ,
402.06.REPAIRS AND MAINTENANCE Tt7 CONNECfl�N
After the initial connection has been made to the water se�me o�e�pine forrconnection`the appi cant ow ef�
{ine or a water service or sewer fead has be�n exte�ded t P R
or the occupant or user of such premises shat{be Iiable far ali repairs required to any�tQ�nerredues�tser lines
necessa►y for connection of the premises from the main to the premise�s�t�e sha14 be charged fur he costs of the
maintenance senrice or repairs be performed by the�tY,the property
maintenance and/ar repairs, indudir�g any necessary street p pu�rant or user to perfo m st ndard maintenance of
policy. it shait be the responstibility of the applicant,owne , p
• the sewer service Ilne from the premises to the rr►ai►t includi�ade�h'i���hat t ema ns above the fi ished he
water senrice curb stop box for operability and at such he�gh
grade of the land or property. (Ref 638,1156,1191)