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Request Number: 9075
Public works Division
Service Request
Problem Address: 6380 Starlite Blvd Requested By: 3oy Peka
Department: WATER Address: No ad�ess provided
Problemllssue: 1NSTALL AMRMEIER Phone Number: 571-8867 or 571-1204
Scheduled Date: 2014-10-13 Scheduled Time: 03:00:00
ACTION NEEDED:2014 AMK
Created by: Wendy Hiatt Date Createdr 2014-10-07
ACTION TAI�N:
Oldmeter#16547088Oldreadi : 1045 60Newmeter#44920823BRT#35172375
Status: Completed Resident Contacted ["'
Date Completed: 2014-10-13 Completed by: Ryan Johason
Hoars
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Request Number: 9075
Public Works Division
Service Request
Problem Address: 6380 Stazlite Blvd Requested By: Joy Peka -_
Department: WATER Address: No address provided
Problem/Lssue: INSTALL AMRMETER Phone Number: 571-8867 or 571-1204
Scheduled Date: 2014-10-13 Scheduled Time: 03:00:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-07
ACTION TAI�N:
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Status: InProgress ResidentContacted ❑
Date Completed: Completed by:
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• • . City of Fridtey
,_ ._ _ . _ Water Department
.__ . . _. . , . ., ,
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
Iiwe hereby autho�ize the�t11 af Fridfe�and/or its o��er
employees to do what is necessary to replace the water meter. 1 w�derstand that the propert�l
ic Iiahle for th water line from the main to the premise and atf iM�riar ptumbing. {Per City code
402.06� i alsa hold the Gtl/ofi Fridley and/its employees harmiess ur any amages maY�
white doing this aperation. This to include,but not limited ta;valves,p�pi�g�+aalls�floors or the curb
stop box and service{ine. I u�derstand I am atso required to obtaln a permit prior to atry wark,if
necessary. � y',��`''
l �
Final meter reading Cotd meter) � �O G _ , �� ��
��:;y
Name: Address:
Phone Num r:
�te: /o �l3'��
5ignature: �
Witness Signature;
fRIDLEY CITY CUDE
�{p�p'�'ER 4QZ,U1►pTER,STORM WATER,A�1�SANITARY SEWER
AdMINfSTRAT{ON
(Ref Ord Nn 113,464,565,566,629,638,662,422,988,1144,1156,1191)
4pZ.05.PERMIT fEE
Prior to canstructing or repair af any water or sewer line connecti�or hall be equ redpo`obt in a permit for such
or buitding for which tfie applicat�on is made,the owner or contra
connectian,and shalt pay a pecmit fe ent QhaN be notifed.tit shaD be untawFul to cover any connecti g�i eeuntil an
made,the Water and Sewer Departm
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06.REPAtRS AND MAIN'�NANCE TO CONNECt10N
������� e service curb sto box or the sewer lead at the propert�
line or a water service or sewer lead has been extended to the property line for connection,the appiicant,owner,
or the occupant or user of such prem�ses shall be liable for ali�epairs required to any wate��i�nQ f�u����n�
�ecessary for connection of the premises from the main t��e p�p�ow`ne shall be charged for the costs of the
maintenance service dr repairs be performed by the City,
maintenance and[or repairs, �n�ud�n�he anelic ntr ownert o�cuPant or user to perfo m st ndard maintenaince of
policy. !t shall be the responsib�ldy o PP
the sewer service line from the premises to tfie main inciuding debris clearing o�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
. ... .. ._ .. . .. . _ -
:,'graite of�tf�e tand or-�rop�tty.�(Re€635,-1�����.�_ __
. .:_. _...._ ._.. .. ._ ._..._
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