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Request Number: 8217
Public Works Division
Service Request :
Problem Address: 425 67th Av�e Requested By: Joe Siedlecki
Department: WATER Address: No address provided
Problem/lssue: INSTALLAMR METER Phone Number: 572-06$4
Scheduled Date: 2014-07-Q3 � Scheduled Time: 07:00:00
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ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 201406-24
ACi'ION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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- City of Fridtey
--- Water Department - - -
64�1 University Avenue NE
Fridley,MN 55432
(763)572-3566
i/we hereby autharize the City of Fridley and/or its
employees to do what ls r�ecessary to reptace the water meter. I understand that the property owner
is Iiabie for the water Hne from the main to#he premise and al!interior piumbing. (Per City code
402.06) t afso hoid the City of F�idley and/its emplayees harmless for any damages that may ouur
while doing this operation. This tu include,but not timited to;valves,piping,wails,floors or the curb
stop box and service line. i understand I am alse required ta obtain a permit prior to any work,if
necessary.
Final meter reading(oid meter) � ��� ��O
Address• ���'� "��
Name: �
Phone Number• Date: + �� �r � 1
Signature•
Witness Sign ture:
FRIDLEY CITY CQDE
CHAPTER 402.WATER,STORM WATER,AND SANlTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144.1156,1191)
402.Q5.PERMIT FEE
Prior to constructing or repair of any wafier or sewer line connecting the existing munir�pal system and any house
or building'for which the application is cnade,the owner or contractor shaif be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Cade. Afte�such connection has been
made,the Water and Sewer Department shail be notified. It shall be unlawful to caver any connecting line untii an
inspection has heen made and such connection and the work inddent thereto has been approved by the City as a
proper and suitabie connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initiatconnection has been made to the water service curb stop box or the sewer lead at the praperty
line or a water service or sewer lead has been extended to the property line for connection,the applicant,awner,
or the occupant or user of such premises shall be liable for atl repairs required to any water(ine and sewer tines
necessary for connection of the premises from the main to the premises. If the prop�tty owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged far the costs of the
maintenance and/or repairs, including any nacessary street repairs,at a rate set annuatly by an administrative
policy. it shalf be the responsibility of the appticant,owner,occupant or user to perform standard maintenance of
° the sewer service line from the premises to the main inciuding 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 tfie land or property. (Ref 638,1156,1191i