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Request Number: 6472
Public Works Division
Senrice Request
Problem Address: 6830 Jefferson St Requested By: John Kaysen
Department: WATER A�ddress: No address provided
Problemlissue: INSTALL METER Phone Number: 763-670-4036
Scheduled Date: 2013-07-26 Scheduled Time: 02:30:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-07-22,
ACTION TAKEN:
Old meter#10702651 Old readin 432 00 New meter#44248411 New reading: 0 ERT#35191386
Status: Completsd Resldent Contacted ❑
Date Completed: 2013-U7-26 Completed by: Pets Gunderson
Hours
7 ��7
Request Number: 6472
Public Works Division
Service Request
Problem Address: 6830 Jefferson St Requested By: John Kaysen
Department: WATER Address: No address provided
Problem/Issue: INSTALL METER(WATER) Phone Number: 763-670-4036
Scheduled Date: 2013-07-26 Scheduled Time: 02:30:00
, `� a� �-,
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-07-22
ACTION TAKEN:
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Status: In Progress Resident Contacted O
Date Completed: Completed by:
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Hiatt, Wendy
Subject: John Kaysen, 763-670-4036, AMR @ 2:30 PM
Location: 6830 Jefferson St NE
Start: Fri 7/26/2013 2:30 PM
End: Fri 7/26/2013 3:00 PM
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 af Fridley and/or its
emp{oyees to do what is necessary to replace the water meCer. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
402.06) I also hold the City of Fridley and/its employees harmiess for any damages that may occur
while doing this operation. This to include,but not limited to;vafves,piping,wa11s,floors or tfie curb
stop box and service line. I understand{am also required to obtain a permit pr�or to any work�if
necessary. � ��
Final meter reading(old meter) �
Name• Address�_ �l.'� �`'r��i� -
Phone Number: Date' �—V����
Signature:
Witness Signature:
FRIDLEY CITY C�DE
CHAPTER 402.WATER,STORM WA7ER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,4fi4,565,566,629,638,662,922,988, 1144, 1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor 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 N1later and Sewer Department shall be notified. It shall be unlawful to cover any connetting Hne until an
inspection has been made and such connection and the wo�k incldent thereto has been approved by the City as a
proper and suitabte connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initia4 connection has been made to the water senrice cur6 stop box or the sewer lead at the property
Une or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shail be liable for ail repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property awner requests
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 by an administrative
poticy. It shall be the responsibility ofi the appficant,owner,occupant ar user to perform standard maintenance of
� the sewer service line from the premises to the main including debris ciearing or raot cutting and to maintain�he
water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)