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Request Number: 9535
Public Works Division
Service Request
Problem Address: 260 Sylvan Ln Requested By: Rod Hustad
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR MEZER Phone Number: 612-366-5946
Scheduled Date: 2014-11-25 Scheduled'ITime: 01:00:00
ACTION NEEDED:Install AMR
Created by: Julie Horak Date Created: 2014-11-24 �
ACTION TAI�N:
Old meter#35048644 Old reading 0428 Newmeter#44921468 ERT#35159364 �
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Statur. Completed Resident Contacted I"`
Date Completed: 2014-11-25 Completed by: Joseph Katzung
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City of Fridley
Water De�artment
Address�� ������ [�
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Name_ ��,(�� tt��j�
Date_ �—p��.�,�
Old Meter Number �
Old Meter Reading � � �
Replacement No:_ ���y��L�_
Replacement Reading �
Replacement Make �� (�
Remarks: , L:G�}� �y�,EZ'"� �
Signed
Request Number: 9535
Public Works Division
Service Request
Problem Address: 260 Sylvan Ln . Requested By: Rod Hustad
Department: WATER Address: No address provided
Problem/Lcsue: INSTALL AMR METER Phone Number: 612-366-5946
ScheduledDa� te: _ 2014-11-25 Scheduled'1Time: 01:00:00
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ACTION NEEDED:Install AMR
Created by: Julie Horak Date Created: 2014-11-24
ACTION TAI�N:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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. - City of Fridley
- _..,. WatRr Dppa��nt
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6431 Unive�sity Avenue NE � �
Fridley,MN 55432
(763�572-3566
�jWe hereby authorf:e the�tY of F�idley and/or its
emplayees to da what is nec�ssary to replace the water meter. I uncierstand'�at the property owner
_isliable for the water tine from the main ta the premise and aN iMe�iQr plumbtng. (Per City code
40x.06) 1 alsa hold the Gty of fridley and/ifi�employees harn+leu or any damages tr�at may oc�.ur
whi{e doing this operation. This to indude,but nat fimtted to;vat�es,piPing�walls�florns ar the wrb
stap box and service line. I understand i am also required to obt�n a pecmit pr+or to any work,ff
necessary. �
�fnai meter reading�oid meter� ��, .�������
Name• Address• �-___�v_�. I V t3'^ Lh
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Phone Nomber: Date: �j(�S'/!y
5ignature� � ���vv�
Witness Signature:
�R{QLEY GTi(CODE
CHAPTER 40I.WATEB,SYDRM W�►TEtt,AND SANC[ARY SEWER
ADMINISTRATIDN �
(Ref Ord Na 113,464,565,5b6,629,638,562,97.�,988,1144,1156,1191j
4Q2.05.PERMIT FEE �
� Prior to constructing ar repair af any water ar sQwer line connecting the existing manicipal system and any hause
or buiiding fnr which the applicatian is madef the owner or coatraetor shatf be tequired to obtain a permit far such
cannectinn,and shali pay a permit fee as pravided in Chapter 11 of thi�Code. After such cannecttan has been
made,the iNater and Sewer Department shall be nutified. It shaA be untawful to caver any cannecting Gne anti!an
inspectiun has heen made and such connection and the worfc incidertt thereto has heen apprnved by the Ciry as a
proper and su'rtable connection.
402.06.REPAtRS AND MAINTENANCE TQ CfINNECT�ON
���� �__�___.....,a+.,ty water servlce curh stan hnx or the sewer lead at the propert�
line or a water service or sewer lead has been extended to the propertytine far cannect3on,the appiicant�awner,
or the occupant ar user of such premises shall be tiable for alf repain required to arry water tine and sewer iines
necessary for cunnecti�n of the prernfses from the main to the premiset. tf tha prope�ty owner requests
maintenance service ar repairs he performed by the City,the praperty owner shall be tharged for the cosk�of the
maintenance and/ar repairs, 9nc�uding any nec.essary strQet repai�s,ak a rate set annuatty by.an administrative
po(icy. �t shaif be the resporuihifity of the appiicant,awner,occupant o�user to perfarm standard mafntenance af
� the sewer service tine from the premises to the main inciuding dehris ciearingor root cutting and to maintain the
water service curh stap box for operabifity and at such height as wiil ensure that it remains above the flnished
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:..g�ait"e of tf��iac+d or�rop�rty.-(Ae�635,Z�5,.;t#�3: .. . .._ ...._ ._. .