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, Request Number: 9067
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Public Works Division I
Service Request
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Problem Address: 6120 Trinity Dr Requested By: Richard Taulelle
Department: WA1ER Address: No address provided
Problem/Lssue: INSTALL AMR METER Phone Number: 5?1-9723 �
Scheduled Date: 2014-10-07 Scheduled Time: 09:00:00
ACTION NEEDED:2014 f1MR
Created by: Wendy Hiatt Date Created: 2014-10-06
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ACTiON TAI�N:
Old meter#97132721 Old reading. 1665 30 Newmeter#44921000 ERT#35159543
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Status: Completed Resident Contacted I""
Date Completed: 2014-10-07 Completed by: Ryan Johnson
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Request Number: 9067
Public Works Division
Service Request
Problem Address: 6120 Trinity Dr Requested By: Richard Taulelle
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMRMETER Phone Number: 571-9723
Scheduled Date: 2014-10-07 Scheduled'1Time: 09:00:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-06
ACTION TAI�N:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed b :
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� � . City of Fridley
_ _. _ Water Department _. _ � _ . _
6431 Universiiy Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the��t11�F�d1eY and/or its owner
employees ta do what is necessary to replace the M►ater meter. t understand that the property
• I:..MI..i
�;,.e.,.�,or the water line from the main ta the premise and al)int�rior ptumbing. (Per City e
4p2,Q6) 1 aiso hcld the City of Fridley andJit�emptoyees fiarmless or any amages ffiat may�o r
whiie doing this operation. This to inc{ude,but nat t+mited to;valves�piP��6,Walls,floors or the curb
stop box and service lin+e. I understand 1 am also required to obtain a permit prior to any wark,if
necessary. �
Final meter reading(old meter) �`�� ��
Name: Address•
(o Z� rr �' ��'
Phone Number:
Date� V��
Signature:
Witness Signature•
F�io��r cmr conE
CH ER 4Q2.WATER,STORM WATER,ANU SANITARY SEWER
ADMINISTRATION
(Ref t3rd No 113,454,565,566,629,638,662,922,988,1144,1156,1191�
4Q2.05.PERMIT FEE
Prior to constructing or repair of any vuater or sewer line connecting�th hall be required¢o`obta n a permit far uch
or building for which the applicat�on is made,the owner or contract
connectian,and shal4 pay a permit fee n�p�af{be notif ed.tt shalt be unlawful to cover any conn icti B ii eeuntii an
made,the Water and 5ewer Departme roved by the City as a
inspection has been made and such connection and the work incident thereto has been app
proper and suitable connection.
402,06.REPAIRS AND MAINTENANCE TO tONNECi10Pf
������ e servi e curb sto box or the sewer lead at the propert�
line or a water service or sewer iead has been extended to the proQQrt1 tine for connection,the applicant,owner,
or the occupant or+�ser of such premises shall be liable for all�epairs required to any wate��i�n�e(n�d�NnQs
necessary for connection of the premises from the main t�„e p ope�ow1ne shall be charged for the custs of the
maintenance service or repairs be performed hy the City, an administrative
maintenance and(or repairs, including any nei��n{ownert occupant or user to perfo m standard maintenance of
poiicy. it shali be the respansibility of the app
• the sewer service line from the premises to t�h�ea �uch he gh as w�'�II ensure hat t ema ns abave the fin shed he
water service curb stop box for operab�ltity a ._
. . ._ -
Ref 635,-��`5,..t�g�:� ... _ ....
"'graite'of t'ne land vr-�rnper[y.�
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