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Request Number: 9175
Public Works Division
Service Request
Problem Address: 6100 Starlite Blvd Requested By: Resik Tin�ic
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Plwne Number: 763-463-8512
Scheduled Date: 2014-10-17 Scheduled 13me: 10:00:00
ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-15
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ACTION TAI�N: �{ Ra
Old meter#89487214 Old reading 173 70 New meter#44921173 ERT#35172577
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Status: Completed Resident Contacted #''
Date Completed: 2014-10-17 Completed by: Ryan Johnson
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Request Number: 9175
Public Works Division
Service Request
Problem Address: 6100 Starlite Blvd Requested By: Resik Turic
Department: WATER Address: No address provided
ProblemlIssue: INSTALL AMR METER Phone Number: 763-463-8512
Scheduled Date: 2014-10-17 Scheduled Time: 10:00:00
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ACTION NEEDED:2014 AMR
Created by: WendyHiatt Date Created: 2014-10-15
ACTION TAI�N:
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Status: in Progress Resident Contacted ❑
Date Completed: Completed y:
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' - City of Fridley
_ - W�*er.Depa�rtment
_ _ _. _ _..: ��,..._ -,
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
i/we hereby authorize the City of Fridley and/or iis
employees to do what is necessary ta replace tl�e water meter. 1 understand that the property owne�
is liable for the water tine fram the main to the premise and all interior plumbing. (Per Gty code
402.06) 1 alsa hcid the City of Fridley and/its employees harmlesa or any amages may�i'-
white doing this operation. Tfiis to inctude,but not limited ta;valves,piPing.walls,�loors or the curb
stop box end service line. I understand I am also required tu ohtain a permit prior to any work,if
necessary.
Final meter readin old meter �� ���
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Name: Address:_,��/�V C y�`' ` _ ` � �
Phone Number: aate: ��/ !'�[ �
M,e,�gu✓ '�`^N r rT�
Signature•
Witness Signature:
�RIDLEY CITY CODE
C R 402.WATER,STORM WATER,AND 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 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 shall be required to obtain a permit for such
connection,and shall pay a permit fee as pruvided in Chapte�],i of this CAde. After such connectian has been
made,the Water and Sewgr Department shall be notified. !t shall he unlawful to cnver any conneding line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper anc#suitabie connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
..p#.��q��{����n rnade to the water service cur6 stoa box or the sewer lead at the propert�
line or a water service or sewer lead has been extended to the propertyline for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all�epairs required to any water line and sewer lines
necessary for connection of the premises fram the main to the premises. If the propetty owner requests
maintenance service or repairs be performed 6y the City,the property awner shall be charged for the cnsts of the
. maintenance and/or repairs, inciuding any necessary s�reet repairs,at a rate set annualiy by an administra8ve
poticy. It shall be the responsi6ility of the applicant,owner,occupant or use�to perform standard maintenance af
� the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water 5erv�ce cur6 stop box for operabifity and at such height as wi{I ensure that it remains abave the finished
.. . _ ._ . .--- ... .
:"gra�e of ti��land or�roperty.�(ReF 638,_l;�,5,.t.���:� ... .. . ._ . _ . . _