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Old Meter Number � � � ��
Old Meter Reading � � '� 3 �
Replacement No. l? �L��
Replacement Reading U
Rep1 acement Make ���'�
Remarks• �(� � �`��'�
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Request Number: 6578
Public Works Division
� Service Request
Problem Address: 6810 Brookview Dr Requested By: Bryce Shimmon
Department: WATER /�dress: No address provided
Problem/Issue: INSTALL METER(WATER) Phone Number: 571-7186
Scheduled Date: 2013-0&14 Scheduled Time: 09:00:00
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ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date C�eated: 2013-0&01
ACTION TAKEN: '
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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Hiatt, Wendy
Subject: Bryce Shimmon, 763-571-7186, AMR @ 9:00 AM
Location: 6810 Brookview Dr
Start: Wed 8/14/2013 9:00 AM
End: Wed 8/14/2013 9:30 AM
Show Time As: Tentative
Recurrence: (none)
Meeting Status: Not yet responded
Organizer: White, Karen
Required Attendees: Hiatt, Wendy
1
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the�ty of Fridiey and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is fiabfe for the water line from the main to the p�emise and all 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 include,but not limited to;valves,piping,Walis,floors or the curb
stap box and service line. 1 understand I am aiso required to ohtain a permit prior to any work,if
necessary. � �Q
Final meter reading(old meter)
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Name:
Address• l�"9 �������11 f:�(
PhoneNumber: Date: � 1�I� ' ✓
Signature: -
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402,WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATIQN :
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144, 1156,1191} _
40Z.05. PERMIT FEE
Prior to const�ucting or repair of any water ar sewer line connecting the existing municipal system and any house
or buiiding for which the application is made,the owner ar cont�actor shalt be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the VNater 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 connectian.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop bax 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 af such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. lf the property owner reque�ks
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 byan administrative
policy. It shall be the responsibii'Ety of the appticant,owner,occupant or user to perform standard maintenance of
• the sewer service line from the premises to the main including de6ris dearing or root cutting and to maintain the
water service cur6 stop box for operability and at such height as will ensure that it remains above the finished
grade of the tand or property. (Ref 638,1156,1191)
Request Number: 7483
Public Works Division
Service Request
Prob�m Address: 6810 Brookview Dr Requested By: Jim Kosluchar
Department: WA'i�R Aufdress: No address provided
Problemllssue: WATER MAIN BREAK(WATER) Phone Number:
Scheduled Date: 2014-02-10 Scheduled Time:
ACTION NEEDED: Water main break
Created by: Wendy Hiatt Date Created: 201402-10
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Com{sleted: Completed by: