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Request Number: 9134
Public Works Division
Service Request
Problem Address; 161 Sylvan Lane Requested By: Matt Field
Department: WATER Address: No address provided
Problemllssue: INSTALL.AMItMETER PhoneNumber: 763-568-4239
Scheduled Date: 2014-10-14 Scheduled'IYme: 09:00:00
ACTION NEEDED:2014 t1IVIIt
Created by: Wendy Hiatt Date Created: 2014-10-13
ACTION TAI�N:
Old meter#94971303 Old reading: 158 10 Newmeter#44920824 ERT#35172410
Status: Completed Resident Contacted !""` `
Date Completed: 2014-10-14 Completed by: RyanJohnson
Hours
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Request Number: 7514
Public Works Division
Service Request
Problem A�ddress: 161 SyMan Lane Requested By: Mait Field
Department: WATER Address: No address provided
Problem/Issue: Phone Number: 763-568-4239
Scheduled Date: 2014-02-15 Scheduled Time:
ACTION NEEDED: Frozen Water Service
Created by: Wendy Hiatt Date Created: 201402-18
ACTtON fAKEN:
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Status: In Progress Resident Contacted ❑
Date Comp{eted: Completed by:
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Request Number: 9134
PuMic Works Division
Service Request
Problem Address: 161 Sylvan Lane Requested By: Matt Field
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nwnber: 763-568-4239
Scheduled Date: 2014-10-14 Scheduled Time: 09:00:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-13
ACTION TAI�N:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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- City of Fridiey
. �_M�te�r�le�+�rtment
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6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
Ijwe hereby authortze the C�t1f of fridley and/or its
employees to do what i5 necessary ta replace the water meter, 1 understand that the property owner
_is liable for the water tine from the main to the premise and ali interior plumbing. (Per City cpde
402.4G) i also hold the�ity of Fridle�r and/i�s employees harmles� or any amages a may u -
while doing this aperation. This ta inc{ude,but nat{imited to;vahres,Piping,vua{Is,floors or the curb
stop box and service tine. I understand I am also required tu obtafn a permit prior to any work,if
necessary.
Final meter reading(old met�r) � O �/�
Name: Address: /�/ �-It��L`�'" "��
Phone Number• Date� r� < ��/
Signature:
Wttness Signatur
FRIpLEY GITY C�DE
TER 402.WATER,STORM WATER,AND SANITARY 5EWER
ADMfNISTRATIOM
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191�
4Q2.05.PERMIT FEE
Prior to constructing ar repair of any water or sewer Nne connecting the ea�sting municipal system and any house
or building for which the application is made,the owner ar contractor shall be required to obtain a permit for such
connection,and shaH pay a permit fee as pravided in Chapter 11 of th'ss C.�de. After such connection has been
made,the Wa#er and Sewer Department shafl be notified. It shail be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has 6een approved by the City as a
proper and suitabte connection.
402.06.REPAiRS AND MAfNTENANCE TO CONNECTION
�#�q�����bas h�n rnade to the water service cur6 stov box or the sewer lead at the propert�
line or a water service or sewer lead has been extended to the propertyline for�onnectian,the appiicant�aw�er,
ar the ocwpant or user af such premises shail be liable for ail repairs required to any water line and sewe�lines
necessary for connection of the premises ftom the main ta the premises, tf the propgCtyr owner requests
maintenance service or repairs be pe�formed 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 annually by an admtnistrattve
policy. It shail be the responsibility ofi the applicant,awner,occupant or user to perform standard maintenante af
• the sewer service tine from the premises to the main including debris clearing or raot cutting and to maintain the
water service curb stop box for operabifity and at such height as wiil ensure that it remains above the finished
. _ . .. . .._ .._ .
:"grade of tf��land ory�rop�zrfy.�(Re�638,-1��5,.1�.43:� .. . ._ . .. . - �