Meter Swap �l ..�� � �
lD�lS�S- L/�%� y'80
Request Number: 9576
Public Works Division
Service Request
Problem Address: 5839-3rd Street NE Requested By: Ste�n Stixtud
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 763-572-2426
Scheduled Date: 2014-12-08 Scheduled Time: 10:00:00
ACTION NEEDED:AMR install
Created by: Cheryl Pellegrin Date Created: 2014-12-04
ACTION TAI�N: ✓
Old meter#191180 9 Old reading:654 60 Newmeter#44421534 ERT#35159170
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Status; Completed Resident Coatacted I''
Date Completed: 2014-12-08 Completed by: Joseph Katzung
Hours
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Request Number: 9576
Public Works Division
Service Request
Problem Address: 5839-3rd Street NE Requested By: Steven 5tixrud
Department: WATER
Address: No address provided
Problem/Issue• INSTALL AMR METER Phone Number: 763-572-2426
5cheduled Date: 2014-12-08 Scheduled'Llme: 10:00:00
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ACTION NEEDED:AMR install
Created by: Cheryl Pellegrin Date Created: 2014-12-04
ACTION TAKEN:
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Status• In Progress Resident Contacted ❑
Date Completed: Completed by:
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- City of Fridley
- , , _. . Wat�?r Departmenfi �
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6431 University Avenue NE
Fridley,MN 55432
(763)57Z-3566
I/we hereby authorize the�t11 of Fridley and/or its
employees to do what is necessary ta replace the water meter. I understand tfiat the ProPertY owner
is 1ia61e for the water line from the main ta the premise and aU interior plumbing. {Per Ckjl code
402.06) 1 aisa hold the Ciiy of Fridley and/it�employees harmle,ssfor any aamages�naz o�r�a.4�
while doing this operadon. This to indude,but not limited to;vafv�s�Piping,walls,floors or the ui�b
stup box and service line. i understand I am also required to olrt�rt a Permit priocto any work,if
, necessary. �
Final meter reading(old meter) ��� ���� .
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Name• Address:�______--._ :
Phone Number. Date� ( `�C�y
Signature•
Witness Signature:
RIDLEY GTY CODE
CF1ppTER 40L WATER,570RM WATER,AN�SANITARY SEWER
ADMINISTRATION ��
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.05.PERMIT FEE �
� Prior to constructing or repair af any water or sewer iine conneeting the e�dsting municipa(system and any house
or buiiding for which the application is made,the owner or contractor shall be required to obtain a permit for such
cannectian,and shail pay a permit fee as provided in Chapter 11 of this Code. After such cannection has been
made,the 1Nater and sewer Department shali be notified. It shall be wlawtul to cover any canne�ing line untii an
inspection has bean made and such connection and the work inciderrt thereta has been approved 6y the Ciry as a
proper and suitable connection.
402.OG.REPAIRS AND MAINTENANCE TQ CONNECTION
����,,�,��Q�� ..� n made tn+gwate�senrice curh stoa bux or the sewer leadatthe propert�
line or a water service ur sewer tead has been extended to the property ime for connectian,the applicant,owc►er,
or the occapent or user of such premises shail be liable for all�epairs required to arry water line and sewer lines
necessary for connection of the premises from the main ta the premises. If the prap�Ity owner requests
maintenance service ar repairs be perfarmed by the City,the property awner shall be t�►a�ged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by.an adminlstrative
paticy. It shall 6e the responsi6ility of the appiicant,owner,nccupant�user ta perform standard maintenance of
• the sewer service line from the premises to the main including debris dearing nr root cutting and to maintain the
. ..
water service cur6 stop box far operability and at such height as will ensure that it remains above the finishe
fte�638,-�.�6,t���:� _. .- - .- . � . . . -
,,,grade of ti��la�al orprope�ty.� . .._ _.._ ... _. .. ..._..