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Request Number: 8137
Public Works Division �� I�
Service Request
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Problem Address: 430 Rice Creek Blvd Requested By: Katy Gunlogson
Department: WATER Address: No address provided
ProbleMlssue: INSTALLAMR METER Phone Number: 571-8481
Scheduled Date: 2014-06-23 Scheduled Time: 08:30:00
ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 201406-19
ACTION TAKEN:
Old meter#18862161 Old reading: �6 90 New meter#44921051 ERT#35171593
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Status: Completed Resident Contacted ❑
Date Completed: 201406-23 Completed by: Ryan Johnson
Hours
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Request Number: 8137
Public Works Division
Service Request
Problem Address: 430 Rice Creek Bivd Requested By: Katy Gunbgson
Department: WATER Address: No address provided
Problemllssue: INSTALLAMR METER Phone Number: 571-8481
Schedukd Date: Scheduled Time: 08:30:00
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ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 2014-06-19
ACTION TAKEN:
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Status: In Progress Resident Contacted O
Date Completed: Completed
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� - City of Fridley
- - - Water Dep�rtment _
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��Wg hereby authorize the City of Fridiey and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabie for the water line from the main to the premise and all interior plumbing. (Per City code
402.06) i also hold the City of Fridiey and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. I understand i am also required to obtain a permit prior to any warfc,if
necessary.
Final meter reading(old meter) `�'�"' � � `�
Name•
Address:_ �✓" e—`f't" �'�'� 'v'—