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Request Number: 9100
Public Works Division
Service Request
Problem Address: 6111 Starlite Blvd Requested By: Sharon Heige
Department: WATER Address: No address provided
Problem/Issue: INSTAI,L AMR METER Phone Number: 763-536-0501
Scheduled Date: 2Q 14-10-16 Scheduled T3me: 03:00:00
ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-08
ACTION TAKEN: f
Old meter#33588696 Old readin 034 40 Newmeter#L�Se�aM��ss F,RT#35172185
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Status: Completed Resident Contacted I""
Date Completed: 2014-10-16 Compieted by: RyanJohnson
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Request Number: 9100
Public Works Division
Service Request
Problem Address: 6111 Stazlite Blvd Requested By: Shazon Heige
Department: WATER Address: No address provided
Problem/Issue: INSTALLAMRMETER PhoneNumber: 763-536-0501
Scheduled Date: 2014-10-16 Scheduled'Itme: 03:00:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-08
ACTION TAI�N:
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Status: In Progress Resident Contacted Q
Date Completed: Completed by
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,� ' � - City of�ridley
Water Department
6431 University Avenue NE
Fridley�MN 55432
(763)57Z-3565
��We hereby authorize the City of Fridfey and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from tha main to the premise and all interior plumbing. (Per Giy code ___
` 402.06) 1 atso hoid the�ity of Fridley andiits employees harrnless for any amages may c
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 1 am atso required to obtain a permit prior to any work,if
necessary. � �D
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fin B f / j
Name• -
Address: ! /����.��i� ""' Cl��i �l/�i-
Phone Number: Date� ! � ���° �
✓�„�
Signature•
Witness Signature:
FR{DLEIf GTY C�DE
R 402.WATER,STQRM WA7ER,AND SANITARY SEWER
ADMINISTRATI�N
(Ref Ord No 113,454,565,566,624,638,662,922,988,1144,1156,1191)
402.45.PERMiT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shail be required to obtain a permit for such
connection,and shall pay a permit fee as pravided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shali be notified. it shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the urork incldent thereto has been approved by the City as a
proper and suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTiON
������q�a��.PPn made to th�y�*er service curb stop box or the sewer lead at the propert�
line or a water service or sewer lead has been e�ctended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shali be liabfe 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 propecty owner requests
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 annuaity by.an administrative
poficy. 1t shall be the responsibifity of the app4icant,awner,occupant or use�to pe�form standard maintenance vf
• the sewer service line from the premises to the main including debris ciearing or root cutting and to maintain the
water service curb stop box far operability and at such height as will ensure that it remains above the finished
_.�__.. _ _ . .. . � _
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_.___.. . . ,- -�-gradeof�he9andorpresper�y. (Re€F38,�5,.239�)_-- -._.. . _ ...._..__ ..:. __ _... __._—_._. _. _.._._ ------------.- --_.