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Request Number: 6895
Public Works Division
Service Request
Problem/�ddress: 6520 Jackson St Requested By: Ronald Scrimshaw
Department: WATER A�ddress: No address provided
Problemllssue: INSTALL METER Phone Number: 571-5810
Scheduled Date: 2013-09-05 Scheduled Time: 10:30:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Fqatt Date Created: 2013-09-04
ACTION TAKEN: v
Old meter#10186843 Old readi 293 60 New meter#44922398 ERT#135159081
Status: Completed Reslderrt Contacted ❑
Date Completed: 2013-09-05 Completed by: Pete Gunderson
Hours
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Req uest N u m ber: 6895
Public Works Division
Service Request
ProblemAddress: 6520 Jackson St Requested By: Ronald Scrimshaw
Department: WATER Address: No address provided
Problem/Issue: INSTALL METER(WATER) Phone Number: 571-5810
Scheduled Date: 2013-09-05 Scheduled Time: 10:30:00
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ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-09-04
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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Hiatt, Wendy
Subject: Ronald Scrimshaw, 763-571-5810, AMR @ 10:30 AM �
Location: 6520 Jackson St NE
Start: Thu 9/5/2013 10:30 AM
End: Thu 9/5/2013 11:00 AM
Show Time As: Tentative
Recurrence: (none)
Meeting Status: Not yet responded
Organizer: White, Karen
Required Attendees: Hiatt, Wendy
1
- 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. 1 understand ihat the property owner
is liable for the water line from the main to the premise and ail interior ptumbing. (Per City cade
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►�+►alls,floors or the curb
stop box and service line. i understand I am also required to ohtain a permit prior to any work,if
necessary. � �o
inal meter readin old meter) �� � �
F g� ,
Name• 1
Address• ����
Phone Number• ,
Date' .���� l�
Signature: �
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION ';i
(Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144, 1156,1191� -
402.05. PERMIT FEE
Prior to constnacting or repair of any water or sewer line cannecting the existing municipal system and any house
or building for which the application is made,the owner or cantractor shall 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 iNater and Sewer Department shall be notified. it shail be unlawful to cover any connecting line untii an
inspectian 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 MA{NTENANCE TO CONNECTtON
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 line tor connection,the applicant,owner,
or the occupant or user of such premises shall be liable for ail repairs required to any water line and sewer lines
necessary for connection of the premises fram the main to the premises. If the property owner requests
maintenance senrice or repairs be performed by the City,the property owner shali 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 uf the applicant,owner,occupant or user to perform standard maintenance af
• the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water service cur6 stop box for operability and at such height as wilf ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)