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Request Number: 9214
Public Works Division
Sernice Request
Problem Address: 6210 Starlite Blvd Requested By: John Gemlo
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR ME'IER Phone Number: 571-2234
Scheduled Date: 2014-10-24 Scheduled 1ime: 09:00:00
ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-20
ACTION TAI�N:
Oldmeter#33588713 Oldreading.064 30 Newmeter#44921478 ERT#35172560
Status: Completed Resident Contacted ('""
DateCompleted: 2014-10-21 Completedby: RyanJohnson
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Name �p� �,MLL"�
Date �—�^�
Old Meter Number � �L�
Old Meter Reading �Z3 � (Y�'�
Replacement No. 5 D ���j �`�
Replacement Reading �
Replacement Make B��
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Signed
R�quest far �en�i�e Repc�rk
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Department: Gikizen Mame: C - .- '
Address: � ��r�����(�i' Caflback Phane: ��� "����� - -
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Scheduf�d Date: l� � � �I � l L'� Proparky Owner.
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Completian Date: ` ��r` : [] Cikizen Nnkified
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� � City of Frid{ey
- ..;. _ wat�r.i�epattment
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6431 University Avenue NE T�"
Fridley,MN 55432
(7G3)572-3566
IJwe hereby authorize the�fi►��dtey and/or its
employees to do what is necessary to replace the water meter. I understand that d�e property owner
�s_liahie fiar the water[ine from the main to the premise and aii interior plumbing. (Per City code
402.06) 1 alsa hold the Gty of Fridley and/its employees fiarmiess or any amages a may -
while doing this operation. This to include,but not limited to;valves,piping,wails,floors ar the curb
�top box and service line. 1 understand I am also required ta o6tain a permit prior to any work,if
neces5ary. � ��
Final meter reading(old mefier) `���
Name: Address: ��jo � }�`' ����
Phone Number ���L��
Signature:
Wl�tness Signature•
FRIDLEY CITY CODE
ER 402.WATER,STORM WATER,ANQ SANI7ARY SEW�R
ADMfNISTRAI'IUN
(Ref Ord No 1�3,464,5�5,566,6Z9,638,662,922,988,1144,1156,1191)
4A2.Q5.PERMIT�EE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building fur whid�the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shali pay a permit fee as pruvided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be natified. It shall be unlawful to cover any connecting line until an
inspection has heen made and such connection and the work incident thereto has 6een approved by the City as a
proper and suitab{e connection.
�402.06.REPAiRS AMD MAIN7ENANCE TO CONNEtTiON
��(��(�(,{��„[,(�[�15P�`I'fA�_n hac haan made to the wate service curb stao box or the sewer lead at the propert�� .
{ine or a water service or sewer lead has been extended to the property line for coanection,the applicant�owner,
or the occupant or user of such premises shaN be tiabfe for a{I�epairs required to any water{ine and sewer lines
necessary for connection of the premises from the main to the premises. If the prop�[ty 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, inctuding any necessary street repairs,at a rate set annually by an administrative
poticy. It shall be the responsibility of the applicant,awner,occupant or user to perform�tandard maintenance af
• the sewer service line from the premises ta the main inciuding debris clearing or root cutting and to maintain the
water service cur6 stop box for operability and at such height as will ensure that it remains above the flnished
. . . .. . . . .. .. . ... .. ... - _.
"grade of tiri�iand or�rop�riy.�(Ref 635,-1#55,-1�9�:� _.