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Request Numbe�: T354 �
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1 � s�enr�e Reque�t : .
i Probtem Address: 681 Ey Strest Requested Byc Debra Wagner
� Department: WA7ER Addre�s: , • '
Probtem/(ssue: TURN WATER�+NOFF(WATER) Ahonm Number: No address prrnAded '
. 763-78R-8781.
. Scheduled Date: 201401-06 3chedulad Time• p4:�0:pp
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: . ACTION NEEDED:Emergency Shut Wafier off �
� Created by: J�r�nie Benson " Date Created• -
� , 201401-06
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, � City of Fridley _
Water Departanent
6431 University Avenue NE
Fridley MN 55432
(763) 572-3561
Uwe hereby authorize the City of Fridley and/or its
employees to do what is necessary to shut off the water at the curb stop box. I understa.nd
that the property owner is liable for the water line from the mai.n to the premise. (Per
City code 402.06) I also hold the Ciiy of Fridley andlor its employees harmless for any
damages that may occur wlule doing this operation. T'his to include,but not lim.ited to,
sod, yard,landscaping,trees, shrubs,driveways, sidewalks or the curb stop box and
service line. i understand I am also required to obtain a permit prior to any work.
Name: Address: ((J 0 1 ��lf S^C'
Phone Number: Date:��
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND BANTTARY SEWER
ADMIl�fI5TRATION
(Ref OrdNo 113,464,565,566,629,638,662,922,988; 1144,1156, 1191)
402.05. PERMiT FEE .. .
Prior to consiruciing or repair of any water or sewer line connecking the e�cisting municipal system and any ' �
house or building for wluch the application is made,the ownerar contractor shalt be required to obtam..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;#he'Water and Sewer Deparhment shall be notified. It sha11 be unlawf�l to cover
any connecting line until an inspection has been made and such connection and the work incident thereto
has been agproved by the City as a proper and siritable connection.
402.06. REPAIlLS AND MAINTENANCE TO CONNECTI4N
Aftar the initial connection has been made to the water service curb stop box or the sewer lead at the
property l�e or a water service or sewer lead has been extended to the property line far connection,the
\ applicant,owner,or the occupant or user of such premises shall be liable for all repairs required to any
water line aud any sewer lines necessary for connection of the premises from the main to the premises. If
the properiy owner requests maintenance services or repairs be performed by the City,the property owner
shall be charged for the costs of the inaintenance and/or regairs,including any necessary street repaus,at a
rate set annually by an administrative policy. It shall be the responsbility of the applicant,owner,occupant
or user to'perform standard maintenance of the sewer service liue from the premises to the main including
debris clearing or root cutking and to ma.intain the water service curb stop box for operability and at such
height as will ensute that it remains above the finished grade of ti�e land or pmperiy. (Ref 63 S, 1156, 1191 j
���
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.
Request Number: 7354
Public Works Division
Service Request
Problem Acidress: 681 Ely Street Requested By: Debra Wagner
Department: WATER Address: No address provided
Problemlissue: TURN WATER OIVIOFF(WATER) Phone Number: 763-784-8781
Scheduled Date: 2014-01-06 Scheduled Time: 04:00:00
ACTION NEEDED: Emergency Shut Water off
Created by: Jeannie Benson Date Created: 201401-06
ACTION TAKEN:
�r��t��Y L�rP�t'�2 S�I�nr ac��= 1�v e.�C��
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�,�....._��:��....................f�...........................:..............................................................................._
............................................................_........................................................_..........___._......................_....._
_......._e��....:.........................._35_��....�'�.y L�::..........................................................:......................
............................................................................_.........................__._.............._._..._..............._
Status: In Progress Resident Contacted �
Date Completed: Completed by:
��6-�
�
� . City of Frid{ey
Water Department
�/� 6431 University Avenue NE
/ � Fridley,MN 55432
V
(Tb3)572-3566
i/we hereby authorize the City of Fridley and/or its owner
� employees to do what is necessary to replace the water mete j{i�e d r p u, mbing.t(PerrCi�Y�e
is tiab{e for the water line from the main to the premise and a
402.06) I also hoid the City of Fridley and/its employees harmless for any damages that may accur
while doing this operation. This to inciude,hut not limited to;valves,pipm�_�orsto any work,if urb
stop box and service line. 1 understand I am also required to obtain a pe p
necessary. �
din old meter) � � �
Final meter rea g(
Name: l ,.� ���- +��c,4' Address: � Z� 1 ��
� �.,,� � �� Date: � ` � � ( �
�� Phone Number: '7 L�7�+—�L--�-�-�—
a`1`���� � � �
Signature�
. �
4��� " r �
Witness Signature:
�.
FRIDLEY C�TY CODE
�, �►-� �� ���� CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
� ADMINISTRATION
(Ref Ord No 113,464,5fi5,566,629,638,662,922,988,1144,1156,1191)
� ERMIT FEE
��..�� 402.05. P
���� �
Prior to constnacting or repair of any water or see�eW�nee o°con��o shall ben equ edtoiabt in a perm'�t for such
or building for which the application is made,th
connection,and shall pay a permit fee as P�all be not fed. It shati be unlawful to cover an�c nne'cti g li eeuntii an
made,the Water and Sewer Department sh roved by the City as a
inspection has been made and such connection and the work incident thereto has been app
proper and suitable connedion.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service�or e�OP�ne forrconnection'the appl cant uwner,
Eine or a water service ar 5ewer lead has been extended to the p p �Y
or the occupant or user of such premises shall be liable for all repairs required to oYe ate�r�lner reques�s r�ines
necessary for connection of the premises from the main to the premises. If the p p rtY
maintenance service or repairs be performed by the City,e t�eraps at awate setaal nua ly by an administrativethe
maintenance and/or repairs, including any necessary s� P
policy. It shall be the responsibility of the applicant,owner,'n�a br s lear ng orroot cutti g and to mai tain thef
- the sewer service line from the premises to the main includ g
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)