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Meter Swap � � Request Number: 15200 Public works Division Service Request Problem Address: 5069 3rd St lteqnested By: Leslie DepartmeM: WATER Address: No address provided ProMem/Isaue: INSTALL AMR METER Phone Numbcr: 763-250-0621 Sel�dnled Date: 2017-OS- � Schednled 1tme: 02:OU:00 ACTION NEEDED: Created by: Wendy Hiatt Ihte Cre�ed: 20U-US-08 AGIION T 1 f 1 • snbmiher a�seea St�: In Progress Ca�acted � Date Completed: eompleted hy: J_°I� `� `.7_' �or � � : 1 �� u��-��-� City of Fridley Water Department �� y�3 /, 6431 University Avenue NE �� Fridley,MN 55432 763-572-3566 �/We hereby authorize the C'ity of Fridley and/or its employees to do wfiat 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 all iMerior plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for arry dam�es that may oavr while do(ng this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand 1 am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) � Name: �'�'i�� l.i Address d rC� Phone Number L�� e ��,�� 1 Signature Witness Signature \ OLD METER#�� Z OLD READING_��l J I I V NEW METER# r 1 rf� �"�� 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 any house or building for which the application is made,the owner or corrtractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as pravfded irt Chapter ii of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notffied. R 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 suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connedion has been made to the water service curb stop box or the sewer lead at the property line or a water servke tead has been extended to the property line for connection,the appliwnt,owner,or oca,�pant or user af 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 owner requests maintenance service or repairs be perfo�med 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 applicarrt, owner,occupant or user to perform standard malntenance of the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the flnished grade of the land or property. (Ref 638,1156,1191) � I��- - � � ��a �� 4 Request Number: 14960 Public Works Division �� ?C'j�� Service Request � ._._______________..____..______._J��'�"" -� Problem Address: 5069 3rd St Requested By: LeRoy Johnson Department: WATER Addresa: No address provided ProWem/jssue: INSTALI.AMRMETER P6oneNumber: 612-205-1960 SchedaledDate: 201?-04-27 � 5cheduled'IIme: 0�:00:00 lrt � c� ,r�r,.. A NEEDI�:D:G4 7'�O SIDE DOOR c � Created by: Wendy Hiatt Date Created: 2U 17-04-26 ►� AC'IION TAI�N: _____.._ ti�5 �� _.._._.�.4�� _._..__.__�.... ._._. Status: In Progress Snbmitter Haa Been �.., Coutacted Date Compteted: Completed by: �- 2� - I � Tb`r � � i • (�- � �(ol(�- 6�' � City of Fridley �Q.��.,. G�� Water Departrnent 6431 University Avenue NE Fridley,MN 55432 763-572-3566 UWe hereby authorize the Ctty of Fridley and/or its empbyees to do what is necessary to rep{ace the water meter. 1 understand that the property owner is Itable fpr the water line from the main to the premise and a{I irKerior plumbing. (Per Ci#y cale 402.06) 1 als�o hold the City of fridley and/'rks employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves.piping,walts,fbors or the curb stop box and seroice line. {n understand 1 am afso required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) v � I � �� Name:_='"`I�„ ��` 1� Address J D'`�� Y� �� Phone Number V?��J ��X�i/ Date__��"— � � Signature Wit�ss Signature OLD METER# `i ��O`I �� OLD READING � v i � L'�'�_ NEW METER# �- 1� �� j� NEW READING � E�# �1222� I g Z �RIDLEY CITY CODE ' CHAPTER 402.WATER,S'TORM 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 constructtng or repair of any water of sewer line connecting the existing municipai system and any house or buildin�for which the • application is made,the owner or contractor shail be required to nbtain a permit for such connection,and sha{I pay a permit fee as provided in Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to wver • any connecting line until an inspedion 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 CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line ar a water service lead has been extended to the property line for wnnection,the applicarrt,owner,or occupant or user of such premises shall be liable for all repairs required to any water fine and sewer iines necessary for connection of the premises from the main to the premises. If the property owner requem mairrtena�ce servite or repairs be perEormed by the Cty,the property owner shall be charged for the costs of the maiMenance and/or repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibi{ity aF the a�licant, owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris ciearing or root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that ft remains above the finished grade of the land or property. (Ref 638,1156,1191)