Meter Swap � , Request Number: 15475
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Public Works Division
Service Req�st
Problem Address: 4763 3rd St Requested By: Crystal Meyer
Department: WA1ER. Address: No a�dress provided
Problemflss�: INSTAL,L ANiR ME'IER Phone Number: 763-228-3935
Scheduled Ds�te: 2017-OS-22 Sc6edule�11me: 01:30:00
U�t�- Z r� ��C�
ACTION NEEDED:
Created by: Wendy Hiatt D�te Cte�ted: 2D17-OS-19
ACIION TAI�N:
�3�r•�,��� ���..-..-�-
Status: In Progress ���tter H�s Been r
Contacted
Date Compteted: �j�-�1``� Completed by: ���
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� City of Fridley � n� � �/�/�r���i1
Water Departrnent V Y «� ���� �
� 6431 University Avenue NE �/
Fridley,MN 55432 �� � (`C�
763-572-3566
��`Ne hereby authorize the City of Pridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City of Fridiey and/its empioyees harmless for any damages that may occur while doing this
operation. 7his 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 READING(old meter) V v �
Name• ��� J+�. � ''y W� Address �� �� J � �•
Phone Number ������ — � �-.JDate �~ �'�'� �
Signature Witness Signature `�
OLD METER#__ �Llr� �U ��9
OLD READING b JCQ� CS c U
NEW METER# _ - 1, 6��O �J
PIEW READtNG �
ERT# ���� �� ��
FRtDIEY CITY CO�E
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATI�N
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permifi for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work inadent thereto has been approved by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water service tead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shall be liabie for ali repairs
required ta any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be perFormed by the City,the property owner shaii be charged for the c�ts of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali be the responsibility of the applicant,
pwner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box for operabil'�ty and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191}
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�(��i4s-yYlv3�rt�
Ci�ty of Fridley
Water Department
Address ��� �� `,�
Name �\C1��,E ���X—
Date—�.(�f�j —l� —
Old Meter Number ��� p
Old Meter Reading (�� _
Replacement No. � c �
Replacement Reading __
Replacement Make � I�Z���'�(--CZ
Remarks• �t-� �� , (ts"2
S igned � _
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City of Fridley
Water Depar�nt
Address �� � �r� ��
Name J Q,Y'a� 1 'ar4 �0�'� -
� V
Date — �� � � "' /�
Old Meter Number � v�
Old Meter Reading �� " �
Replacement No. � J�� � �
Replacement Reading
Replacement Make
j��d. .er
Remarks: �� -�`► ��'` �
l'' �
Signed -
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Request Number: 10506
Public Works Division
Service Request
Problem Address: 4763 3rd St Requested By: Wayne with AAAPlumbing
Department: WATER Address: No address provided
Problem/Issue: TURN WATERONlOFF Phone Nnmber: 651-770-1263
Schedule ate: 2 5-09-03 Scheduled'I�me: 07:00:00
� �
ACTION NEEDED:Turn off water for repair.Leave key.Permit in process.****BILL***
Created by: Wendy Hiatt Date Created: 2015-09-01
ACTION TAI�N:
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Status: 1n Progress Resident Contacted L�
Date Completed: Completed by:
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