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Request Number: 8974
Public Works Division
Service Request
Problem Address: 200 Christenson Way Requested By: Mike Vant
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-759-6624
Scheduled Date: 2014-09-29 Scheduled Time: 02:00:00
ACTION NEEDED:2014 AMR Phase 2
Created by: Wendy Hiatt Date Created: 2014-09-25
ACTION TAKEN: � V
Old meter#96311749 Old reading 065 70 New mete�Used=old bra�L�tT#35171951
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Status: Completed Resident Contacted 1'`
Date Completed: 2014-09-29 Completed by: Ryan Johnson
Hours
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Request Number: 8974
Public Works Division
Service Request
Problem Address: 200 Christenson Way Requested By: Mike Vant
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-759-6624
SchedWed Date: 2014-09-29 Scheduled Time: 02:00:00
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ACTION NEEDED:2014 AMR-Phase 2
Created by: Wendy Hiatt Date Created: 2014-09-25
ACTTON TAI�N:
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Status: 1n Progress Resident Contacted ❑
Date Completed: Completed y:
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. - City of Fridley
_..._ � _ ,_R. _., _.._.,. Water Depa►tment _. ,._.�
, �._ ._._ ,.�_ ,. _._ ._ _._
6431 University Avenue NE
Fridiey,MN 55432
(763)572-3566
��We hereby authorize the�t11�F�diey and/or its
empioyees to do what is necessary to replace the water meter. 1 understand that the praperty owner
��ia�hip f�r+hg water iine from the main to the premise and all iMerior plumbing. (Per Gty code
402.06) I also hold the Gty of Fridiey and/its employees harn►less or any amages a ma`y�-
while doing tf�is operation. This to include,but nat limited to;valves�p�p��g►Wa{Is,floors or the curb
stop box and service line. I understand 1 am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter? V �� �«�Q
Name:
Address• �� �"`� � ����t�y�✓
Phone Number:
Date: ����/
Si nature: �� ��`���
6
Nfltness Signature:
FRIDLEY C17Y CODE
APTER 4U2.WATER,STORM WATER,AN�SANITARY SEWER
ADMINISTRA710N
(Ref Ord No 113�464,565,566,629,638,662,922,488,1144,1156,1191)
402.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line conne a�or sh 11 be required o!bt in a permit fo�such
or building for which the application is made,the owner or con
connectian,and shall pay a permit fee as pruvided in Chapter 11 uf this Code. After such connection has been
made,the Water and Sewer Departmonnectilon and tthe work incident theret'has been pp ove by the Ciry as an
inspection has been made and suth c
proper and suitable connection.
402.06.REPAIRS AND MAtNTENANCE TO CONNECTION
���� service cu�6 sto bux or the sewer lead at the propert'
line or a water service or sewer lead has been extendei!to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all�epairs required ta any watorwlner re ��r lines
necessary for connection of the premises from the main to the premises. If the propg�iy q
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 ctearing or root cutting and to maintain the
_ . ..__. ... ._ .
water service curb stop box for operability and at such height as will ensure that it remains abave the flnish
_ � � .. . .. .
Re�€638,_1�5,_t3��:� _�
,,:. __ _. _....._ ._. _ ... ._..._ . . . _._. _ .... ..._..
graife of ttie land or�ro�erEy�