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Request Number: 7082
Public Works Division
Service Request
ProblemA�ddress: 841 MISSISSIPPI Requested By: RICHARD ZEGLAND
Departmerit: WATER Address: �1 MISSISSIPPI
FRIDLEY, MN 55432
P�oblem/Issue: IHSTALLAMR METER Phone Numbes: 612-839-6818
Scheduled Date: 2013-10-03 Scheduled Time: 07:30:00
ACTION NEEDED:AMR
Created by: Jean Michaeis Date Created: 2013-10-01
ACTION TAKEN: �
Old rr�eter#93107385 Old reading. 127 t�tew meter#44922494 ERT#Ki5159109
Status: Completed Resident Contacted ❑
Date Completed: 2013-10-03 Completed by: Scott Bradseth,TaybrAnd�erson
Hours
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Req uest N u m ber: 7082
Public Works Division .
Service Request
_ . _
Problem Address: 841 MISSISSIPPI Requested By: RICHARD 7FGLAND
Department: WATER Address: �1 MISSISSIPPI
FRIDLEY, MN 55432
Problemllssue: INSTALLAMR METER Phone Number: 612-839-6818
Scheduled Date: 2013-10-03 Schedufed Time: 07:30:00
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ACTION NEEDED: AMR
Created by: Jean Michaels Date Created: 2013-10-01
ACTION TAKEN:
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Status: In Progress Resident Gontacted �
Date Completed: Completed by:
Hours �
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_ City of Fridley
Water Department
6431 University Avenue NE
-� Fridley,MN 55432
(763)572-3566
I/we hereby authorize the�ty of�ridley andJor its o�ner
� employees to do what is necessary to replace the water meter. 1 understand that thp PC��e
is liable for the water line frorn the main to the premise and afl iMerior plumbing. (
402.06) I aiso hold the City of Fridiey andJits emploYees ha�o�valvest piping,wal�s,flc°rs r the curb
while doing this operation. This to include,but not I�mrted , .
stop box and service line. i understand I am also required to obtain a permit prior to any work,if
necessary. �� ���
Final meter reading(old meter� � �
Address: V� ` / ' 1`�l�1
Name• �
Phone Nu Date: �v�� �
Signature: �
Witness Signature:
FRIDLEY tITY CODE
CHAPTER 402•WATER,STORIIA Wp►TER,AN�SAN�TARY SEWER
ADMINISTRATIaN
(Ref Ord No 113,454,565,565,629,638,662,922,988,1144.1156,1191) y
4�2.05. PERMIT FEE
Prior to constructing or repair of any water ar sewer line connecting the existing municipal system and any house .
or building for which the appiication is made,the owner or contra f this Cadee After such conne tian has been uch
connection,and shalf pay a permit fee as provided in Chapter 110
made,the 1Nater and Sewer Department shall be d the work ncid nt theret�ol has been pp oved by the City as a n
inspection has been made and such connection an .
proper and suiCable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb�OA'ne forrconnect onl the appl ca C owner,
line or a water service or sewer lead has been extended to the property
or the occupant or user of such premises shall be liable far all repairs required to any wate��ner requests r��nes
necessary for connection of the premises from the main to the premise�s�ne shall be harged for the cosCs of the
maintenance service or repairs be performed by the City,the property
maintenance and/or repairs, including any necessa ownert o cupant or user to perform standa d maintena'nce of
policy. It shall be the responsibility of the applicant, .
• the sewer service line from the premises to the main including deb�is clea�ing o"r root cutting and to mairttain the
water service curh stop box for operability and a#such height as will ensure that it remains above the fiinished
g�ade of the land or property. (Ref 638,1156,1191)