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Request Number: 6840
Public Works Division
Service Request
ProblemAddress: 6650 Jackson St Requested By: Mr Famham
Department: WATER Address: No address provided
Problemllssue: INSTALL METER Phone Number: 571-1142
Scheduled Date: 2013-09-04 Scheduled Time: 01:30:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-OS-28
A TI N T EN• �1
C O AK .
Oid meter#32194767 Old reading 23 60 New meter#44922425 ERT#35159549
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Status: Completed Resident Contacted (7
Date Completed: 2013-09-04 Completed by: Pe�Gunderson
Hours
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Request Number: 6840
Public Works Division
Service Request
Problem Address: 6650 Jackson St Requested By: Mr Farnham
Department: WATER Address: No address provided
Problemllssue: INSTALL METER(WATER) Phone Number: 571-1142
Scheduled Date: 2013-09-04 Scheduled Time: 01:30:00
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ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-08-28
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 University Avenue NE
� Fridley,MN 55432
(763)572-3566
I/we hereby autharize the City of Fridtey and/or ia owner
employees to do what is necessary to replace the water meter. I understand that thp pCit�a e
is liabie for the water line from the main to the premise and all interior ptumbing. ( fi(
402.06) I also hold the City af Fridiey and/its employees ha��m�valves,piping,walls,floar's or the curb
while doing this operation. This to include,hut not Umrted ,
stop box and service line. I understand 1 am also required to obtain a permit prior tu any work,if
necessary. �� ��� —
Final meter reading�ald meter)
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Name:
Address: � � �
Phone Number. Date: �`� `�t�
Signature:
Witness Signature:
FR{DLEY CITY CODE
CHAPTER 40Z.WATER,STCIRM WATER,AND SANtTARY SEWER
ADMINlSTRATIQN
(Ref Ord No 113,464,565,566,fi29,638,b62,922,988,1144,1156,1191) _
40t.05.PERMfT FEE
Prior to constructing or repair of any water or sewer line connecting the all be emu redto'abtain a permit fo�r such
or building for which the appiication is made,the owner or contractor sh q
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be rtotified. It shalt 6e unlawfui to cover any oved by he City as a�
inspection has been made and such connection and the work incident thereto has been app
propec and suitable connection.
402.06.REPAfRS AND MA{NTEMANCE TO CONNECTION
After the initial connectian has been made to the water service curb stop box or the sewer l t�d appt�n��W er,
line or a water service or sewer lead has been e�ended to the property line for connection,
or the occupant or user of such premises sha(I be liable far all repairs required to any wate�line and sewer lirtes
necessary for connection of the premises fram ihe ma�n to the premis owne shall be harged for the costs of thQ
maintenance service or repairs be perfarmed by the City,the property
maintenance and/or repairs, inciuding any nei'cantr owner,occupant or user t�pe�form standard maintena+nce of
poticy. It shall be the responsibility of the app
• the sewer service line from the premises to th�mauc�nh�dn ad w���nsure hat i emains aba e the�+n shed e
water service curb stop bax for operabitity and at s g
grade of the land or property. (Ref 638,115fi,1191}