Merer Swap � �
�
� � �
�� � �
� �
� � Request Number: 6845
Public Works Division
Service Request
Problem Address: 6575 Monroe St Requested By: Don Holum
Department: WATER Address: No addr�s provided
Problem/Issue: INSTALL METER Phone Number: 571-9042
Scheduled Date: 2013-0&30 Scheduled Time: 08:00:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-08-29
ACTION TAKEN: ✓
Old meter#13477360 Old reading 157 0 IVew meter#44921342 ERT#35159027
.._...._._..___.�.....�....._.......__._..__...__.___......_._..._.____..._.._.__.._..__._._.._....._...._.._..__..._...._..__...._.._.__...._..__..__..._._....____....�..___...�..._
Status: Completsd Resident Contacted O
Date Completed: 2013-0&30 Corr�leted by: PetB Gundersa�
Hours
L.��J 7
Request Number: 6845
Public Works Division
Service Request
Problem Address: 6575 Monroe St Requested By: Don Holum
Department: WATER Address: No address provided
ProbleMlssue: INSTALL METER(WATER) Phone Number: 571-9042
Scheduled D te: 2013-08-30 Scheduled Time: 08:00:00
� ��� ;�n�
U('
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-0&29
ACTION TAKEN:
..........................................................................................................................................................................................................................................................................................................................................................................................................:......M
'
..............�...,����.........._�......................_�.._�_�._�7.......���......��.........................__............_.._...._._...:.........__...__..._._._.___.................:............__......_..._
..................c...�..._���s�..:'........._......................._i....���._�.._�C�.._._.._...................:......:..............................................................._..........__.........._..........__........:._..........._
�� /n��� � u�a� 1�3�1�;
..............................................................................................................................................................................�.........__...�._......................................................................................................................._..........................._...____........................_
�� �����- �s
.................................. ........ .......................................................................................................___...._.....___..............�...................................................................................................................:................................................................._............_..._
�� � �3 �;��c�a�1
........:...................................................................................................................................__......_...�................................................................................................................................._................._........._............._........................................._..__.._............_
Status: In Progress Resident Conta�ted O �
Date Completed: Completed by:
-- .� �j!\�►'�17�
� �
�
- City of Fridley
Water Department
6431 University Avenue NE
- � Fridtey,MN 55432
(763j 572-3566
I/we hereby authorize the City of�ridley and/or its
employees to do what is nece5sary to replace the uvater meter. 1 understand that the property owner
is Siable for the water tine from the main to the prerr►ise and aU interior plumbing. (Per C'rty code
402.06) 1 afso hold the City of Fridiey and/its empfoyees harm{ess fur any damages that may occur
while doing this operation. This to include,but not limited#o;vatves,piping,wails,flaors or the curb
stop box and service line. 1 understand i am also required to obtain a permit prior to arrywork,if
necessary. ���
Final meter reading(oid meter)
Name�
Address: �� ! � /1�P`i��-L��
Phone Number•
�ate: �._'�Q.� ��
Signature� �� ( `'"�"���
Witness Signature:
FRIDLEY CITY CQQE
CHAPTER�#02.WATER,STdRM WATER,AND SANtTARY SEWER
ADMINfSI'RATiON
(Ref Ord No 113,464,565,566�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 shaN be required to obtain a permit for such
connec�ion,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the 1Nater and Sewer Department shail be notified. lt shafl be untawFuf to cover any connecting line unti!an
inspection has been made and such cannection and the work incident thereto has been approved by the Gty as a
proper and suitable connection.
402.06.REPAIRS AND MAINTEI�ANCE TO CONNEC710N
After the initial connection has been made to the watec service curh stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property!'►ne for connectian,the applicant,uwner,
or the occupant or user of such premises shaii be fiab{e for af{repairs required to any wate�line and sewer lines
necessary far connection of the premises from the main ta the premises. {f the property owner requests
maintenance service or repairs be performed by the City,the property owner shail be charged far the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
palicy. lt shatl be the responsibility of the applicant,�wner,occupant or user to perform standard maintenan�e of
• the sewer service line from the premises to the main including debris ciearing or root cutting and to maintain the
water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the iand or property. (Ref 638,1156,1191j
Ftequest t�u�ervic�e R�
Ci�y►of Fri+dl�:y
#3ef�t�_ �-12-5337' Date: 91'2�0l�12
Reque�t Tppe= Sew�back�checi�c�r n�ain Er#er�Fly: INe�dy Fiatt
. 5erxer Qiz�Na��e: Cian 4�n
Ade�ess� �75 MONR�E ST ME Cabas�Cc P�xx�e: 7�71-9a42
Sc�u� D�c: P�ape�y Owner:
i:ncati�� : F�,est U�ela�7x: Fio�is F�g bac�a�a�d sa
ae twQ r�bors fo the nath af h`rs
F�t�e-
,�cfian Tak�:
;
,
3
�
i
I
�
i
i
3
,
� ,
i .
�
� �
�
; �
�
l
i
F�paRs�ie P�: � ,
__._--� - -- _. -� _��_ _. _ .
i
�� � � l
C,�1�t�e: � �iti��Vc��ec!
__. _� ! �..._ __�
R��st f� ',�rv�io� Ft
+Gti�y c�f Frid�
� �� �-�2-�� ��: �r�or�+a�2
�r�� �hac�c�p��radc{�r.� EDy�
_ � t�rt�e� E3arx�
Ad�: �75 M0�5T"I� �a�a�ic P�e� 7�1-�42
�d 0�= �+ar�
_ iieqe�rat L�a�s: N�eas�era la�ing bada�ard aa
a�e t�o���e�ro�r d�
��oi■e_
Ai�m Ta�:
E3t3r�i�dear. T�ed�#�n�ec.
�____..�._
�
�
�_______ .._ __. �. _
+Ga�pid�ac��e: n/2�JZU121:��t � �� �(�zers�
_______ �,,.�._�.._.___..... _...,.� �