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Meter Swap " ReqUest f�r �ervHce Repvtt . Cfiyr of Fridl�y ��u�: s�-��-�zo� ��: 7r�rla�z � T�� Tre��i�� e,r: w�� t��,t: s� cc��,ra�: ��e� Ad�: 532 6+�TH AVE NE C�rad€Phon+e: 763-574-023�a Sc�edul�d [�te: 1ftU;f�D1�" l�PM '��Q� �ty�: Lflea�i+�i�ek�s: ��d Detail�: T\i►Sewe�Se�oe A�tia�n Tak�: �� _ ��c� -��,s�,. � (�o �a�� cs��,�-�� ` �� `��Q�-� b� �.� �. ao�� s�. . � � � � I , � � � � � � � I � , . ; � i � i f f Re�ans�e P�: � �`�—�� -�-� _ . __ � R .�QY�'� �� v - (,t1�f'�7��11711�E: , �12Ex1� � �l b �.��`Z� � ' Reque�� f�r �ervice R�rt r City flf Fndl�y Referen�IUc�: �2-12-�2s [��: lf�s#2o12 Request Type� TV aewer aervice tine Errtered By: W�dy f��t flep�rtmer�: Sew� {atizen�J�ne: B�bara 8aran Ad�ess: '�2 6£TN 14VE NE C�adc Phone: 763-574�0�3a "Sc�dul�d Qete: if1�1� 1�PM �1V+��ct�� Prraperty(�nme�: Loc�ian De#ails: Had lir�tvd 1.�1U112 but�e needed to � Uefail�_ Tlf Sewec Service have her�e cfeaned�txd+�r t4 g�,#aN t�e way ta the m�.l�is ncrw deaned. ,�ti�n T�cen: �-v . �� 1;.�..� C�� ; �.^ � � 1.� �`1 j � i � � i E E � � � � � � '��-� ;.�„;r �� d. i'��' . R+�aar��e P�: �� , � ` . �f Aj _ L�__ t._, �_ f ,�,►�_ �� _ _ Ct��ian L'�e: ' ' ; C�xex�N�d � � � �� -� F��qt�� f�r�er�t�: R �ifiy�f Frid1� � �: �-�z e: 1110f�12 �qt�Tj�= I�e d�t�Ma� �t�!�r: �: . �s�iaEact l�ddae�: ��TH hVE�E �rac�P�one: �5�74-0"�35 Stfiedt�xd[I��= �� P�ITt3�r: �� iequ�t Ikta�s: T _ �`'� ��1.Q.G�rv�.. �..� ��"� ///�/ �, I lJJ 1/`v �sJ�s[.�"C.� � l+� _ a � �_..._ � _..........___w__.. � i � �t�e: � 4�ar;�ta� I-13 �/ �� _a_� �_ ��a � � � _.....� � ._....� �.�.�.. ...��._. . � �V��'-�i.Zl� � � ------__..��. .�.___.._____�.....�_...y � �� -� �.. ......__.__._,._ _._ ...__ ___...�____w______-- , �� ="n�ad�� _._-___ _.___. .�.---__..____�.....�_ __. �_.._ _...___.. ._ .___ �__._ _. _. _._.. _.._.._.�._...� � � E I � '�� "�PJ1.t _ � _ -paue�p,�u�;�"��+�► �� 5�S AL ='�� 4' ��ZiJ'�ll�.��' ��+�3 !fd�L�1�./6lll ��P� �CS�'E�L � �3l1'V F#1�'9� =�PPM' fn�"�T[I �"^'�M� � �� .�� ..,...��Al =�1� Z�.�Bt�l �� '��`Zt�9 ��ef �� ''�1l�1�.�� u�e�� f+�r�nric�� R�p�rt Ci�y of Frici�y , .��. -�2 ��: -�nor��z �T�: t��r w� �: . � . �� _ ��rrE� �� a-a� s�a�= �r��a��=ao�*a �c�: ��: � �: �.�-��a��a an�icla�r Jw_ �t3�►�in �� Ac�Ta�� ar� . ' �d�ar_ , � � � �� c_.�.__.._____.___-_---- --.... ....�..._.__W__._---- _ ..._��-- �'i �C�g� � " �t+e� 1I�3r2i?l��.19� ; f�ar� .� � � a�e _ �e �.. ....__ ��_ _� �..� � R�q�uest fc�r ',�er� R Ci#y a�f Fridi�y ��: �-�z-�o� ��: v�a�r�2 �T,�� rr�� a�: �c . � �.e� �: ��r�r a�v�� : ��o-�oa� ��: ��»�� : _ ��= ivr s�s�,� ��u +�� . � �►. � � � � � � � I�� __-___.._ ___._�_� �_.._.____________ . __.___�.__.______ ��e_ �tl12l2C1��3:19 E�+t E�ran� � _��__� .._�. _� _�, R�que�t fi�r�er�t�: R��# �i�.y c�f Fridl� __ �: �-12-�4�01 [�a��: t,t�f2012 T�e� N s�r��re 5��c1�: 1�i�dy �� Se� �z�r�: Ba�ara Baean ,�Idd�� 6�'sTH A'�E� . 76�?+4-D� S�d iJ�+e: 111�1�1�F"!1 �p�jrt3w�r: ��: � �s= 7Y Sewer Sen�se TaC�� t�2. [)ttUar� on�ie. �20i2 � . , � 1 � � � � I � � , --- --.__._.. .___.__��W..______.__._...._. _........ ...___�.._...._�___._._____.._.__. _ �. �� Fa�san� �9 �_.._...._._�____��.._.��__._ ___..___..._�_�..____ . �1/�1l'ZOi2 8�l�# i 4 i._. _...... �...F,A�..._._.. ..._. �...___.a . ..._...,... . � Request Number: 7999 Public Works Division Service Request Probfem Address: 532 66th Ave Requested By: Barbara Baran Department: WATER �uldress: No address provided Problemllssue: INSTALLAMR METER Phone Number: 763-5740235 Scheduled Date: 2014-06-09 Scheduled Time: 01:00:00 � � ACTION NEEDED: 2014 AMR Created by: Wendy Hiatt Date Created: 201406-05 ACTION TAKEN: ...............................................................................................................................................................................................................................:..........................................................................................................................................................................._......_ .....d.......�...�............��.....�...... .........D....._......5..........C......v.......�._1...._�...�....................................................:.......................:.........................:.........._._........_......................�:......_ � _..d.1...�.................��................. .....�.......�...Z�...1..:...1.....�....�.................:........................._..............................................................._....................................................___....�........_....__.._........._ � . ......1�.�.........._�,�:��::._�.........�..........._�'._�-�_�...�...�............................................................................................_...........................................__.........:............................................ ......�u.�........:...._��.:......................-.........: ...............................................:. . � � ............................................................................................................................................................._......._................_......._......_._.___................ ......._�..e.-�1...�............�..�....... .5.........�..�....`�.�:..g_�................................................................................................................................................................_............................_................................_...._....._ Status: In Progress Resident Contacted ❑ Date Completed: Completed : �s�� * - City of Fridley Water Department _ 6431 University Avenue NE Fridiey,MN 55432 (T63)57Z-3566 I/we 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 all interior plumbing. (Per City code 402.06) I also hold the City of Fridley and/its empioyees harmless for any damages that may accur while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb stop box and service line. i understand 1 am aiso required to obtain a permit prior to any work,if necessary. Final meter reading(old meter) �� '` � Name• Address• �� `�� v Phone Number. Date• .��` � Signature• ��'�`- � Witness Signatare: FRIDI.EY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.05.PERMIT'FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shali be required to obtain a permit far such connection,and shaN pay a pe�mit fee as provided in Chapter 11 of this Code. Afte�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 propec and suitable connection. 402.06.REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service turb 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 shaii be iiabte for atl repairs required to any water line and sewer tines necessary for connection of the premises from the main to the premises. If the propetly owner requests maintenance service or repairs be performed by the City,the property owner shail be charged for the costs of the maintenance and/or repairs, including any necessary street repairs,at a rate set annually byan administrative policy. It shall be the responsibility of the applicant,awner,occupant or user to perform standard maintenance of ° the sewer service line from the premises to the main inc{uding debris ctearing or root cutting and to maintain the water service curb stop box for aperability and at such height as wili ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)