Meter Swap 13��5-�320
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Request Number: 9095
Public Works Division
Service Request
Problem Address: 6400 Starlite Circle Requestec!By: Syl�ster Maciej
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME'IER Phone Number: 572-0686
5cheduled Date: 2014-10-09 Sc6eduted 15me: 10:00:00
ACTIONNEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-08
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ACTION TAI�N: �
Oldmeter#34628375 Oldreadi :094 20 Newmeter#��l�e oldbrass:ERT#35159541
Status: Completed Resident Contacted !""'
Date Completed: 2014-10-09 Completed by: Ryan Johnson
Hours
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Name��/Y�, ��,`�"y�
Date__ (, r-�-�g
Old Meter Number � Q� D
Old Meter Reading �
. Replacement No. Z�
Replaceme�t Reading �
Replacement Make �('�,
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Signed
Request Number: 9095
Public Works Division
Service Request
Problem Address: 6400 Stazlite Circle Requested By: Sylvester Maciej
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 572-0686
Scheduled Date: 2Q 14-10-09 Scheduled T�me: 10:00:00
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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 �
Date Completed: Completed by �
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Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)57Z-3566
�/We hereby authorize the City of Fridley andJor its
employees to du what is necessary to repiace the water meter, i understand that the property owner
__. is Iiabfe for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) t also hold the Gty of Fridley andJits employees harmtess�or any amages�iat may a�iTr �- "���-� �
while doing this operation. This to include,But not fimited to;valves,piping,walls,floors or the curb
stop bax and service tine. 1 understand i am also required to obtain a permit prior to any work,if
necessary,
Final meter reading(old meter) � � �����
Name: Address: � � G� t"" �r `� l�t 1�(.�v
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Phone Number: Date:
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Signature• � '
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Witness Signature•
FRIDLEY UTY CODE
CH R 402.WATER,ST�RM WATER,AND SANITARY SEWER
ADMINISTRAI'IDN
(Ref Ord Ma 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.U5.PERMfT FEE
Prior to constructing or repair of any water ar sewer ltne cunnecting the existing munictpa!system and any house
or buiiding fo�which the application is made,the owner or contractar shail be required to obtain a permit for such
connection,and shal{pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shail be notified. !t shall be unlawful to cover any connecting line unti{an
inspection has 6een made and such conneetion and the work incident thereto has been appraved by the City as a
proper and suitable connection.
402.06.REPAIRS AND MA{NTENANCE TO CONNECTION
�,#,�r-�k�..iaitial con�ectiian.ba���made to th�rater service curb stop box or the sewer lead at the propert�
fine or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises sha{I be fiab{e for all repairs required to arry water fine and sewer fines
necessary for connection of the premises from the main to the premises. tf ihe prape�ty owner requests
maintenance service or repairs be performed hy the City,the property owner shail be charged for the costs of the
maintenance and/ar repairs, inciuding any necessary 5treet repairs,at a rate set annuaNy by an administrative
policy. It shafl be the responsibility of the appiicant,owner,occupant ar user to perform standard maintenance o#
• the sewer service line fram 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 finished
_ _.. . _..__. . ._.. .__ - . .. . . .__ _.
_ ,:'gratte of ti�e tand orprop�tiy. �Ref 638,-��5,_1�93:� __ .� . . .