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City of Fridley
Water Department
Address � ! �( t�j }�u-'�:�' �
Name � C� c-c�v� � l"t.�l�'y7
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Date �j ,� �/ � l C� -
Old Meter Number � �� D 7
Old Meter Reading �d
Replacement No. �� �� � 3�� � �
Replacement Reading C�
Replacement Make ��%'(�'P�"'
Remarks: r�'Gt�� !.� ?'���d'�
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S igned ��(/�����"""
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Request Number: 10364
Public Works Division
5ervice Request
Problem Address: 194 63rd Way Requested By: Zacharie Boroto
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-823-6181
5cheduled Date: 2015-08-06 Scheduled Time: 01:30:00
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ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2015-07-27
ACTION TAI�N:
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Status: Tn Progress Resident Contacted �
Date Completed: Completed b •
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Hiatt, Wendy
Subject: Zacharie Boroto 612-823-6181 AMR install for Non Responder list--New Owner
Location; 194-63 Way NE
Start: Thu 8/6/2015 1:30 PM
End: Thu 8/6/2015 2:00 PM
Show Time As: Tentative
Recurrence: (none)
Meeting Status: Not yet responded
Organixer: Hara, Sandra �
Required Attendees: Hiatt, Wendy
1
- Gty nf Fridley
- . ._ -:... WatPr Department
6431 University Avenue NE . - . . , -
Fridley,MN 55432
(763�57Z-3565
I/we her�by authurize ihe�hl��dtey and/or its
employees to do what is necessary to replace the water meter, I understand that the pr+npe►�tY own�'
e water line from the main ta the premise and atl int�rior plumbing. (Per C.it�i code
402.06) I.alsa hold t�e City of 6ridtey andJits employees harn�5 r any amages a ma �
white doing this operation. 'fhi�ta indude,but nat limited to;val�es�piping�walls,floors or the curb
�top box and service line. I understand i am afsa required to�a Pe�rt P��t°any wo�ic,if
necessary.
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final meter reading(ofd meter) ,
Name: Address:_ ��`�'�� ��� . .
Phone Nu Date• �✓ �"r�� '
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTE4i 4qZ.WATElC,5'fORM WA'fER,AND SANITARY SEWER
AdMINlSTRAttUN
(Ref Ord No 113,464,565;566,629,638,66Z,9�2,988,1144,1556,1191)
4AZA5.PERMR FEE �
Prior to constructing or repalr of any water or sewe�Iine connectingthe adsting muniap�l system and acry house
ar building for whlch the applicatian is made,the owner or contrac�r sha11 be required ta obtain a permit for such
canaectian,and shall pay a permi�fee as provided in Chapter 11 of this Code. After such connection ha�beer
made,the Water end Sewer Department shall be notified. It shail 6e unlawful to tAver any connecting 1'ine until an _
inspection has been made and such connection and the work inddentthereCo has 6een approved by the C1ry as a
proper and suitable�onnectfon.
402.06.REPAIRS AND MAINTENANCE TO CONNEC7'1t�1d
��A� __ __ �...,.,+,,,�,a warer service curh staa bax or the sewer lead at the propert�
fine or a water service or sewer{ead has been extended to the propertyline far cannection.the applicant�owner,
or the ocwpant or user of such premises shatil be liabte inr all�epa�reqaired�o any water line and sewer lines
necessary for connection of the premises from tfie main ta the pr�ni�es. {f the prop�[ty owner requests
mai�tenance service ar repairs he performed by the City,the property owner shail be t�arged for the co�ts of the
. maintenance and/or repairs, induding any neces5ary street repairs,at a rate set annually by.an administtative
poticy. It shall be the respansi6ility of tt►e aPP��cant,owner,occupant a user to perform�tandard mainkenance of
the sewer service line from the premi5es ta the main inctuding dehris dearing�r root cutting and to maintaln the
water service cur6 stop hox for operabilltY and at suth heiBht as u�l�n�ure that it remains above the�nished .
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