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Meter Swap , j"`� Reques# for Service Report ; �ity af Fndley Re#�renc�t�Jc�: �-12-4fi&S �a�e: 5��'2f2Q12 Fie�quest Tpp�� TY�a+ervice lir� Ente�eci�� W�t�r Hi� �artmer�t: Sew�r Ctizen Name: 6ic Ada�n Ad�= 491 67TH AVE NE C�adc Phone: 612�r18�2 Sc�duled Date. �J71�{I12 1�OOAM mO(�C�y Prnpeity(h�ne�: Loca�ican Detaas: � Fi�� tleta��: Televise se�rer serrice_ 2t}12� � Adic�T�cen: ���Q�.S�G.�. ��j�"� c�d\2_ ,�-`�.�� �r �� 't�t� ����� T—`" ' � �-� `�- � i � i i � � � I € S � E 7 � 7 � i ( i � � I � ...... ._..._ ._� _,,. _..,._, _,..____...� :. ... ..... ...___ ...... .. ...... ........ ..... . ...... ........._.. � �,�P,�,: �,�,��C� __ _ �w�: ��� C�leSian[�ate: � 0 C�z�I�f'aed �- -7 ��, !'� F��t�� fi+�r� - �t+�r� �it�c�f Fr�cil� . �: �-�2-a+� ���: ��z T�e� Tv��i�e� �jr: � . � �l�e: E�!�i'r� Ade�.s�: +�31 6ffi7�1 A1iE I�IE fi��: �12-�-1�62 �il�e: �i'l�1Z lA-AQ�i �p�e�j+t7�wnri: Loc�e��a�s: �iegrr.�t]etais= Telewe�ewer xnicae_ Zt112� � �Tat�u�: TYc1�,17J"12. and " �e+��e. � � i � � � � � � � � CraMg E�t�r . E�oeia�Perso�� �� �� � " i �_____....._ ._...____....___.. ____...._�_...._..__�.._.. t)at+e� ��/2�120��'����1#�! C�en N�a�ed � __ - —_ _ _� _ � Request Number: 8152 Public Works Division Service Request Problem Address: 491 67th Av�e Requested By: Eric Norton Department: WA"IER Address: No address provided Problemllssue: INSTALLAMR METER Phone Number: 612-845-0122 Scheduled Da • 201406-24 Scheduled Time: 07:30:00 1�.251.�� � :3 ACTION NEEDED: 2014 AMR Created by: Wendy Hiatt Date Created: 201406-20 ACTION TAKEN: ................................................................................................................................................................................................................................................................................................................................................................_._..............................................._ ........_�.,� ..._�h:��:..._�..........-........................�_ba�......�o..... ....... .......................:_................................................................_..:................................._.........................................._._ c�.o � � _........._o�....._��a_�....-................................��..._�.��.................................................................:........................._....................................................._...._._................:W...............__.� . ..........._��..._��-z�-�..................�.'�.q.._�.....:�._�.._y_�........................................................................................._.................:...._........_.............._..._._._.__.._...__......_ ��J�►,s� — , _........_,Ilf�....................................._.............................................................................................._..........................................,...................:................................................................:............._. ........_..................._............................................._........._ _..........................._�-�"...........�..-........................._3....5.._I.._�........I.._�3�........._......:......................................__...........:........................_......._.........._.__........._M................................................._.._ Status: In Progress Resident Gontacted ❑ Date Completed: Completed by: �- ���- , � , City of Fridley Water Department _ . 6431 University Avenue NE Fridley,MN 55432 (763)572-3566 ��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 properly owner is liable for the water line from the main to the premise and ali interior plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to inciude,but not limited to;valves,piping,walis,floors or the curb stop box and service line. I understand I am also required to obtain a perrriit prior to any work,if necessary. Final meter reading(old meter) L� � Name• Address• ��� ����� . Date• �" '1 Phone Nurnber• `.`Z � Signature• Witness Signature: � FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRA710N (Ref Ord No 113,46�4,565, 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 shaU be required to obtain a permit for such connection,and shatl pay a pe�mit 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{ine for connectian,the appticant,owner, or the occupant or user of such premises shall be{iable for aN repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the propeCty owner requests maintenance service or repairs be performed by the City,the property owner shall 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 wiil ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)