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Request Number: 14715
Public Works Division
Service Request
ProMeie Addresa: 5084 Cle�view St Requested By: 3ay Gilbertson
Departmeut: WATER Address: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-366-1240 "
Scheduled 2017-04-28 � Scheduled TIme: 02:00:00
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ACTIUN NEEDED:
Created by: Wendy Hiatt Date Created: 2017-04-17
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ACTION TAI�N: '�"
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Status: In Progress Snbmitter Has Been r
Contacted
Ds�te Completed: ����,i I� Completed by: `',,,
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tra o�nEaiea a�easnit�arioir�o,a►ay rv�srf�,�necessara�e
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Prior to cor�structirsg oc c-epasr esf arry�►a�er of sewer�i+ae connec�ing the e�sts'rgg municipai systerrr end arry i�ouse or brx7ding far evhic.h#
applicativra is made,the o�►ner or corrtra+ctor shatt be�eajuired i�obtairs a pernait for such connec�tion,and sFrali pa'/a E+erm;t fee as prrn�i
Cha�oter 3.�of th�s Code_ A�er such ctsnneciion has beer+rnade,i�re�!t'ater and Sewe�Departmern shaif�+e�aofifiecl, R sha(1 be untawhtl4
aray�vna�ectang line urr�il an irrspection has 6een anade and�ch connedaon and the work Tnciderrt thereto h�been aPP�d by the C'it�j
pro�er and suitab�e connectio�a.
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�fter tfse sssr'ta'at connectivn has been made�the wafier service curb stoP brnc or fi�e sewer lead at fii�e property�icse ar a�ater�en+ice iea�
f�een extended#o fihe prvpesty line for con�aectiar�,�►e appTcartt,ow�er,Qr accupas�t or user af�u.fi premises shali be Aafale fvrati re�sair
rec�uire�t to arsy wa�er l�ne and sewer lines a�ecessary#ar connecfiion vF tne�xemtses frorn the main to the�emises. �f tite p�arme,
requests ma�rrtenance service ar repairs f�e performed by t�se�rtY.tfae}�-Qperty r►wner shall be cf�arged for the�Cs o#the maim�rram:e a
repairs,inciudirag ne+cessary sd eet repairs at a rate sefi aranuai(y b�an administra�e�so�icy, tt sf►ai!be ifie s•espa�i6i["rty of the aPP��,
awreer,accuparr,t or user to perfv+rrt�standard mairrtertance aF the seaver sererice l�ne fi�om�Ite premises to fifie rnain�rrd��de�uls dearic
roat�atting and tv anairreain the water servi+ce cur(s sta�box far ogeeaisstity an�at sttch height as xnTl ensure tha�t iC rem�ns abwe the fini:
grasie of�kl�e 4anc3 or properiy. �Ffef 638,Zaa6,1191)
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City of Fridley
Water Department
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Address �
Name wa
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old Meter Number � ✓ � S
Old Meter Reading � �� —
Replacement No.
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Replacement Readincr
Replacement Make 0. ��
Remarks: � �C� �e'
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Sign.
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