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� Request Number: 8213
Pubtic Works Dinrision
Service Ft�equest
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ProbN�m Address: 285 Rice Creek Bivd Requ�ted By: Lynn Johnson
� Department: WATER Address: I�address provided
Rroblemllssue: INSTALLAMR METER Phone Number: 763-586-9779
Scheduted Date: 2t31407-0'f Scheduled 7ime: 08:30:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Greated: 2014-06-24
� ACTtON TAKEN:
ald meter#40413579 Oid reading:�160 New meter#44921106 ERT�Ki5171624
. Status: Compteted Reslder�t Contacted �
Date Completed: 201407-07 Completed by: Ryan Johnsvn
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City of Fridley
Water Department
Address d�0 � ���e C i�C'e� l7�(/C�
Name .�C d"�'�` �d�l�-SOn
Date , ' — � � � v -
Old Meter Number � � � � f ���
Old Meter Reading a' � � 3 �
Replacement No. � d �'� � 3 S � �
Replacement Reading �
Replacement Make � ��"�"'��
Remarks: t�.c� / , �e.�(�,
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Signed ,�`
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Request Number: 8213
Pubiic Works Division
Service Request
Problem A�ddress: 285 Rice Creek BA�d Requested By: Lynn Johnson
Department: WATER �uldress: Nb address provided
Problem/Issue: INSTALLAMR METER Phone Number: 763-586-9779
Scheduled Date: 2014-07-0 Scheduled Time: 08:30:00
�_ C� I � g i�
ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 2014-06-24
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Comp by:
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• - City of Fridley
� - � Water Department _ __. _
6431 University Avenue NE
Fridley,MN 55432
(763)57Z-3566
IJwe hereby authorize the City of Fridfey and/or its
empfoyees to do what is necessary to repface the water meter. I understand that tfie property owner
9s liable for the water line from tfie main to the premise and all interior p{umWng. (Per City code
4a2.06) !also hoid the City of Fridley and/its employees harmiess for any dart�ages that may occur
while doing this operation. This to iaclude,but not timited to;vatves,piping,walis,floors or the curb
stop box and service line. 1 understand i am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meterM � `��� ` �
Name: � Address: �0� �(\�-L- l./ �1G- '�J(�V�
Phone Number: Date: �( � r�
Signature: ��
Witness Signature:
� FRIOI�If GTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINtSTRATION
(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 ar sewer line connecting the existing municipal system and any house
or buiiding for which the application is made,the owner or contractor sfial{be required to obtain a permit for such
connectian,and shetl pay a permit fee as provided in Chapter 11 of this Cade. Afte�such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION �
After the initia!connection has been made to the water service cu�b stop box or the sewer lead at the prnperty
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shali be liabte for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the prop�tty owner requests
maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the
maintenance andior repairs, induding any necessary street repairs,at a rate set annually by an administrative
policy. It shal!be the responsibility of the appticant,owner,occupant or user to perform standard maintenance of
• the sewer service line from the premises to the main including deb�is clearingor root cutting and to maintain the
water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)