Meter Swap 6
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Fridley
Requcst Number. 17570
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rr�btee�Addreu: 4844 2nd St R�uostsa Sy: Marp�rita Risra Barl�eelfa
Dep�rt�tut: WA'IER Ad�rass: No adtireait pE�c►vided
ProWtmRsane: FROZENN ME`TER ?he�N�r: 612-A23-8384
Sclied�i�1)ate: 2018-01- „� Scbedoled 11as: 11:00:00
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�LCIiUNNEEDED:Fmzenmeter.•sssg�,ss.s
Cre�tedby: WendyHiatt DateCre�ed: 2018-01-12
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stat�: In Progress 3nb�ttter xa.Boe. �
Co��cted
Date Co�leted: �� r„v�7 Co�leted by: ��f�� �
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City of Fridley �� / ' / - C�17� _ L--�
Water Department � l� � � `'� �� ! v � 1
6431 University Avenue NE
Fridley,MN 55432
763-572-3566 �
I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and ail i�rterior
plumbing. (Per City code 402.06) I also hold the City of Fridley andrts employees harmless for any damages that may oca�r white doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIN I m r �� " � ���✓ � � �� r� � �����GPC�" ;
G(od ete ► ���,
Name: �fA�A a.r�� t�.1[7� f���U�"Address � � ` � �� '�
Phone Number VG���' �Oi�_�v�Date ��v 1� `�~ �V
�Signature Witness Signature
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OLD METER# 4 r� V� �� SIZE & STYLE ICircle)
OLD READING ���� 1 I �� J ` 5/8" �
NEW METER#_ r �/�O� � v I , 1" HEX
NEW READING �/ 1�4" ELIPTICAL or HEX
ERT# � l �a��c�c� 2" ELIPTICAL or HEX
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
A�MINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line�nnecting the existing municipal system and any house or building for which the
application is made,the owner or cor�tractor shall be required to obtain a permit for such connection,and shall pay a permit tee as provided in
Chapter ii of this Code. After such connectlon has been made,the Water and Sewer DepartmeM shall be natified. it shall be unlawful to w�rer
any conneding line until an 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 REPAIRS AND MAINTENANCE TO CONNECI'ION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for con�ection,the applicant,owner,or occupant or user of such premises shall be liable for aN repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owr�r
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the p�emises to the main Pncluding debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the tand or property. (Ref 638,1156,1191)
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` Request Number: 14767
Public works Division
Service Request
Problem Address: 4844 2nd St Requested By: Margarita
Department: WATER Address: No a�ress provi�d
Problem/Issue: INSTAL,L AMR ME'lER Phone Number: 612-423-8384
Scheduled Dxte: 2017-04-24 5cheduled 1lme: 10:00:00
�
ACTION NEEDED:
Created by: Beth Ko�lrick Date Created: 2017-04-18
ACTION TAI� :
__._....._.._._�.w� __.....�._ ��''�- _.___._�.._..__
_.........._.........._.....____ .-__._.___.._ _._ � _._._........._....._.._.....__..._...__
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Status: In Progress Sabmitter Has Been �..
Co�Acted
Date Completed: Completed by:
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City of Fridley � � ���J�
Water Department
6431 University Avenue NE
Fridley, MN 55432 �
763-572-3566
�/we hereby authorize the City of Fridley and/or its emplayees to do what is ntcessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all iMerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am aiso required
to obtain a permit prior to any work,if necessary.
FINAL METER READIMG(old meter) � sJ� � � �
Name• I Address �� 1 ` U/41 ��
Phone Number � ' �ate ��"��" ��
Signature__ \v/ \ Yllitness Signature
OLD METER# ���Vl )� ,'�
OLD READING � �010 � lG�fl
NEW METER# � i � D6i� �
NEW READING �
ERT# ����� { � +�-
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and aey house or building for whith the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any conneding line until an inspection has been made and such wnnection and the work incident thereto has been approved by the City as a
proper and suitable co�nection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service airb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of such premises shall be liabie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the appiicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including delxis clearing or
root cutting and to maintain the water service curb stop box for operabil'�ty and at such heigfit as will ensure that it remains above the flnished
grade of the land or property. (Ref 638,1156,1191)
� � Request Number: 11742
Public Works Division
Service Request
Problem Address: 4844 2nd St Requested By: Margazita
Department: WATER Address: No address provided
Problem/Issue: NRN WA'IER ON/OFF Phone Number: 612-423-8384
Scheduled Date: 2016-07-21 Scheduled 1ime: 12:45:00
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ACTION NEEDED:Turn off water for repair.Leave key.Permit#2016-01701 *'�**BILL****
Created by: Wendy Hiatt Date Created: 2016-07-20
ACTION TAI�N�
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...............................................................................................................................:.................................................._....................................................._......................................__.._..........._._.....__............................................._..__....._........__................
............................................................................................................................................................................................................................................................_...............................................................____.__.._..._..............................................._
Status: In Progress Submitter Has Been �
Contacted
Date Completed: Completed by:
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Request Number: 10482
Public Works Division
Service Request
Problem Address: 4844 2nd St Requested By: Amy w/Norbloom Plumbing
Department: WATER Address: No address provided
ProblemlIssue: TURN WATER ONJOFF Phone Number: 612-827-4033
Scheduled Date: 2015-08-25 Scheduled Time: 01:00:00
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ACTION NEEDED:1lirn off water and leave key.Advised Amy to pull pemut.****BIL,L****
Created by: Wendy Hiatt Date Created: 2015-08-25
ACTION TAI�N:
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......................................................................................................................................................................................................................................................................................................_._.............._�_.........___._......_..__.........__............_.__
Status: In Prog�ess Resident Contacted �
Date Completed: Completed by:
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