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Request Number: 6728
Public Works Division
Service Request
Problem A�ddress: 710 Par�dora Dr Requested By: Roxanne W hiteoak
Department: WA'fER Address: No address provided
Problemllssue: INSTALL METER Phone Number: 571-4013
Scheduled Date: 2013-0&23 Scheduled Time: 08:00:00
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-0&15
ACTION TAKEN: / /
Old meter#18685740 Old reading:431390 New meter#44921448 ERT#35191739
Status: Comp�ted Resident Contacted O
Date Completed: 2013-0&23 Completed by: Pete Gunderson
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Request Number: 6728
Public Works Division
Service Requesf
Problem�4ddress: 710 Pandora Dr Requested By: Roxanne W hiteoak
Department: WATER Address: No address provided
Problemllssue: INSTALL METER(WATER) Phone Number: 571-4013
Scheduled Da . 013-08-23 Scheduled Time: 08:00:00
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ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-0&15
ACTION TAKEN:
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Status: in Progress Resident Contaated ❑
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 authorize the City of Fridley and/or its
employees to do what is necessary to replace the water rneter. I understand that the property owner
is liable for the water line from the main tothe premise and all interior plumbing. (Per City tode
402.Q6) I also hold the City of Fridley and jits employees harmless for any damages that may occur
while doing this operation. This to inctude,hut not limited to;valves,piping,walis�floors or the curb
stap box and service line. I understand i am also required to ohtain a permit prior to any work,if
necessary. ������
Finat meter reading(old meterj
Name: Address: ��� r A���
Phone Number: Date: V���s--�--
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Signature:
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Witness Signature:_, ��"'�—
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANtTARY SEWER
ADMINlSTRATIC/N
(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 municipai system and any house
or building for which the appiication is made,the owner or contractor shal!he reqaired to obtain a permit for such
connectian,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the V�tater and Sewer Department shall be notified. It shall be unlawful to cover any conneding fine ur+ti!an
inspection has been made and such cannection and the work incident thereto has been approved by the City as a
proper and suitable connection•
402.06.REPAIRS AND MA{NTENANCE TO CONNECi'ION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property
Iine or a water service or sewer lead has been extended to the property line for connettion,the applicant,owner,
or the occupant or use�of such premises shall be liable far ail�epairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner 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
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
• the sewer service line from the premises to the main including debris clearing or root tutting and to maintain the
water service curb stap 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}