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City o! Fridley
Water Department
Address t���� 1-����dW �_
Name . � OS�D"F� �
Date_�-��-�.
Old Meter Number "I
Old Meter Reading
Replacement No.
Replacement Reading �
Replacement Make ��j�
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Remarks:��,�-!Z(�`'C�,� ��
Signed
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Request Number: 7055
Public Works Division
Service Request
Problem Address: 6780 Brookview Dr Requested By: Joseph Kapala
Department: WATER Address: No address provided
Problemllssue: INSTALL METER(WATER) Phone Number: 571-7418
Scheduled Date: 2013-09-30 � Scheduled Time: 07:30:00
1
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-09-26
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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. City of Fridley
Water Department
6431 Uni�ersity Avenue NE
- y Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridiey and/ar'� ���r
employees to do what is necessary to replace the water meter• I understand that tfie P P��e
is liable for the water line from the main to the P�'o ees harmless fo rany dam,ages thatmay occur
402.06) I also huld the City of Fridley and/its emp y
' while daing this operation. This to include,hut not limite too�bta n a perm t/pnorst°anY"�°ke�curb
stop box and service line. i understand 1 am alsa required
necessary. � �d � �
Fina)meter reading(old meter) �
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Name: Address:
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Phone Number: Date:
5ignature:
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Witness Si ture:
FRIDLEY CITY CC1DE
CHAPTER 402.WATER,Sl'ORM WATEiI,AND SANtTARY SEWER
ADMINISTRATI�N
(Ref Ord No 113,464,565,56G�629,638,662,922f 988,1144,1156,1191) _
402.05.PERMIT fEE
Prior to constn.�cting or repair of any water or seweWlnee o�cont acto shall be equi ed to abt in a pe nirt for such
or building for which the appiication is made,the o
connection,and shali pay a permit fee as Pha{f be not f e�d.tit halt be unlawful to cover anyconne'cti g�in until an
made,the Water and Sewer Department s
inspection has been made and such cannection and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initiat connection has been made to the water service curb stop'ne forrco nectionl the ppl cant owner,
4ine or a water service or sewer lead has been extended to the property
or the occupant or user of such premises shall be liable for all repairs required to any�+atO�ner reduests r��nes
necessary for connection of the p�emises from the main to the premiseow'ne shall be charged for he costs of the
maintenance service or repairs be performed by the City,the property
maintenance and/or repairs, including any necessary s�e ft�pu rant or user to perfo mYstanda d maintenance of
policy. It shall be the responsibility of the applicant,aw , P
• the sewer service line from the premises to the main incle d�n adeb II ensure hat t emauins abo e the fin shedthe
water service curh stop box for operability and at such h g
grade of the land or property. (Ref 638,1156,1191)