Meter Swap :�
�
Request Number: 15077
Pubtic Works Division
Service Request
Problem Address: 5228 Capitol St Requested By: Beth Williams
Department: WA'lER Address: No address provided
Problem/Issue: INSTALL t1MR ME'IER Phone Number: 612-290-9238
Schednled Date: 2017-OS- Scheduled'Ilme: 07:00:00
�U�s � ��` 7�
y
ACTION NEEDED:
Created by: Wendy Hiatt Dite Crented: 2017-OS-01
ACIION TAKEN: '
.�. s�.c I�' �R—_
Status: In Progress Sabmitter Has Been �,
Co�acted
Date Compteted: �,�'��_ �, Completed by: ���p
Honrs
��
� , .
� . t � O� � 1"�✓ ���r OV
t �
, City of Fridley �� � �� /
Water Department ���
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/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 iMerior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may oaur while dang this
operation. This to include,but not limited to valves,piping,wails,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.
FINAI METER READING(otd meter) ����� �`�'
Name: �'NL �1 i l�I°G�-w.`7 Address ���g �b t �C� >� �
Phone Number � t�`r�� �^ �2�� Date � ` � j�
—•�
Signature Witness Signature
OLD METER# ��% ! � �CO�3
OLD READING �� l�� �/�v
NEW METER# � f �U �`�' � �
NEW READING �
ERT# � �� I 6 � ) ,
FRIDLEY CITY CODE
CHAP7ER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATIOW
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to construding or repair of any water of sewer(ine connecting the existing municipal system and any house or buildiog for which the
application is made,the owner or wr�tractor shalt 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 connedion has been made,the Water and Sewer Department shail be not�ed. It shall be unlawful to rnver
any connecting tine until an inspection has been made and wch 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 connectton has been made to the water service curb stop box or the sewer lead at the properly line or a water senrice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises sha11 be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premtses. if the property owner
requests maintenance service or repain be performed by the C'ity,the property owner shall be charged for the�of the mair�tenance 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 premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability a�d at such height as wiil ensure that it remains above the fnished
grade of the land or property. (Ref 638,1156,1191)
�
Request Number: 7791
Public Works Division
Service Request
Problem Address: 5228 Captial St Requested By:
Department: WATER Address: No address provided
Problemllssue: WA1ER MAIN BREAK Phone Number:
Scheduled Date: 201404-18 Scheduled Time:
ACTION NEEDED: Water main break
Created by: Wendy Hiatt Date Created: 2014-0421
ACTION TAKEN:
n � � � ��� ���'��`�
I{ ���e
_..................................................................................�.'..........................................................................................................................................................................................._............................_.............................................................................__.._.........
_ .....................................:............................'."����...�.....�....:...........:�.....�.....::�1........�..��:::::� ,t......�................................:......__............_.._..........�._................_.............____....
_................................................................................................................................................................................................................................................................................._............................................................................._......................................_..._.........._
....................................................................................................................................................................................................................................................................................................................................................................._..__....._....._..................._._....
_..............................................................................................................................................................................................................................................._.............................................................................................................................................._......_.................
....................................................................................................................................................................................................................................................................................................................................................................................._.................._........_
Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
� � , � ���� ���
`� `� � y �
�