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Request Number: 7129
Public Works Division
Service Request
Problem A�ddress: 1015 Mississippi St Requested By: Hani Omar
Department: WATER A�ddress: " No address provided
Problemllssue: INSTALL METER Phone Number: 612-730-7424
Scheduled Date: 2013-10-18 Scheduled Time: 02:30:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-10-11
ACTION TAKEN:
Oid meter#17286618 Old reading: 524 10 New mete�F �`�b�/�tT#35171940
Status: Completed Resident Contacted ❑
Date Corr�leted: 2013-10-18 Completed by: Pete Gunderson
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Request Number: 7129
Public Works Division
Service Request
ProblemAddress: 1015 Mississippi St Requested By: Hani Omar
Department: WAIER Address: No address provided
Problemllssue: INSTALL METER(WATER) Phone Number: 612-730-7424
Scheduled Date: 2013-10-18 Scheduled Time: 02:30:00
" i '� r.� c3-`•3d
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-10-11
ACTION TAKEN:
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Status: In Progress Resident Contacted O
Date Completed: Completed by:
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. . City of Fridley
Water Department
6431 University Avenue NE
� Fridley,MN 55432
� (763)572-35fi6
t/we hereby authorize the City of�ridiey and/or io Own�
emplayees to do what is necessary to replace the water meter. 1 understand that the���e
is liable for the water line from the main to the prem�es harm�ess fo rany damyages that may occur
402.06) I aiso hoid the City of Fridley and/its employ �� ���5����ar the curb
while doing this operation. This ta include,but not limited to;vatves,pip' g.
stop box and service fine. i understand I am atso required to obtain a permit prior to any work,if
necessary. � � �
� � �
Fina1 meter reading(old meter) ' �,•
Name: Address:
��1 ( C7 �l$`�'FSSi�
Phone Numbe .
Date: � ��� ��
Signature•
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANiTARY SEWER
ADMINISYRATION
(Ref Ord No 1Z3,464,565,566,629,638,662,922,988,1144,1156,1191) _
402.05. PERMIT FEE
Prior to constructing or repair of any water ar sewer line connecting�h hall 6en equi edto bt'n a perm'd for such
or building fo�which the application is made,the owne�or contractor s
connection,and shall pay a permit fee as pro�be n t fi ed. It hatl be un{awfut to cove�any conne'cti g lineeuntil an
made,the Water and Sewer Department shal roved by the City as a
inspectian has been made and such connection and the work incident thereto has been app
proper and suitable connection.
402.�6.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop'n�f�°�connection'the appl cant owner,
F1ne or a water service or sewer lead has been extended to the property
or the occupant or user of such premises shafl be�ya�aen to the p emisesu if he p operly owner requests r��nes
necessary far connec tion o f t h e p re m i s e s fr o m t h e m
maintenance service or repairs be performed by the City,
the property owner shal t be c harge d f o r t h e c o s t s o f t h e
maintenance and/ar repairs, includ'+ng any neces s a ry Wn(t D�pupant or ser to perfo m standard ma ntentance a f
policy. It shall be the responsibility of the appticant,o ,
• the sewer service line from the premises to the main including debris clearing or root cutCing and to maintain the
water service curh stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)