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Meter Swap . , �� - �.� 22�D "�3 . So � 3aa�- " , Request Number: 14841 Public works Division Service Request Problem Address: 6633 Central Ave Requested By: Shannon Department: WATER Addreaa: No address provi�d Problem/lssue: ,�,,,��'.4LL AMI�i1�'L�R . �� P6une NuA!ber: 1-218-831-2876 ri.. j'� C{ ��y�o�..��"t"�'�° f�"�'��'i'C� I/+� �:� I"`��J�!1a-r�a� Scheduled D . 2017-04-21 Schednled 1lme: 09:00:00 1 S�— ACTION NEED . o v�afzr so, *��c�"n � �" �R. Created by: Wen�y Hiatt Date Created: 2Q 17-04-20 ACTION TAI�N: �o�vt Z.,i'ci �C,�� c�t' �-/ ,�� P.r.--- � � ....�=�1c,.�� t�--� � l ? ��-� � _._..._.__..___�� 1� �� ___.-�._._ 5��/ -� _T�4��.� 7 � � l .______...��'.�� l � � � S Status: In Progress Sabmitter Has Been r Contaeted Date Completed: Completed by: ` � _ f_ ��/ � � i � Gity of Fridley , �Jatex Department � 6431 University Avenue NE ' Fridley MN 55432 ' (763) 572-3561 Uwe hexeby authorize the City af Fridley andlor its employees to da what is necessary to shut affthe water at the cuzb st4p box. I understand t.�at the progerty own.er is liable for the water line from the main.to the premise. (Per Ciiy code 402.Q6) I a3.so hold#he City of Friclley andloz its emplc�yees hannless for any damages that may occur while doing this operation. This to include,but not limited to, sod,yard,landscaping,trees, shrubs,driveways,sidewalks or the curb stop box aaad service line. i understand I am aLso requized ta obtain a pemsit prior to any wo� Nam.e: Address: Phone Number: Date: Sigr�ature: Witness Signature: � FRiD�LLY CTTY Ct3DE CHA.PTER.402.WATER,STURM WATF.R.AND 5ANI'TARY SEWF�R AD��VISTRATIOlu (Ref OrdNo 1i3,454,565,566,629,638,662,922,988,1144, i1S6,1391} 4U2.Os. PERMT.f ITE Prior tti canstructiu�oz repair of any watex��sewer line cannecting the ex�stin.g municipal system and any honse ar bw7.ding for which the applicstion is made,the owner oz cAmtra.ctor shall be requfred ta oM�in a pem�it for such co�mection,aad shali pay a.penm�it fee as provided in.Chapter I1 of tbis Code. A�er snch commecfiian has been made,the Wa#er an.d S�wer Dep�hmient shall be no#ified. It slialt be unla.w.fi�l to cover any connectiug live until au inspection has been made and such comie�tion a�i.d the work incident thereto has been aggrov�d by the Crtp as a proper anc�srz�able coimectian. 402.06. REPAIRS A1�TD 11�NANCE TO COlYNECTIUl`d A$er tha initia.l conn.ection has been made to the water service curb stop box ar the sewer lead at the properiy line or a wat�r service ar sewer lead has been.egtended to the PrflPestY l'me for eoo�uiectian,the agplica�t,owner,or the occupant or user of such pre�mises sball be Iiable for all.repairs req�m�eei tfl a�y water li.n:e�d anp sewer lines necessary for cannection of the premises from the m.ain tio i�e pre�mises. If the praperiy owner requests maintenauce services or repayrs lae per�ormed by the City,the prope�ty owner sb.all.be charged for i3�e costs af ti�nlauntenance�nd/or repairs,including any necessary street repairs,at a rate set annually by sn a�m;ni�trative policy. It shaI1.be the responsib�lity of t�h.e applic�ownez,occapant or user ta'perform stand�d.m�enance of the sewer sezvi.ce 1'me�Zom 1i�e pze�ises i�the msin in.clud'm g debris cleaorim�g or rocrt cutting and to maintain.the water service cm�b stap boa for operab�ity and at such hei.ght as will ensute that it remains abave the fmnsh�ed grade of the land or propea�y: (Ref 638,1156,I191j City of Fridley Water Department 6431 University Avenue NE Fridley, MN 55432 763-572-3566 �/We hereby authorize the City of Fridiey 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 all irnerior piumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may ocwr while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understa�d 1 am aiso required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) Name• Address Phone Number Date Signature Witness Signature OLD METER# OLD READING NEW METER# 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 ar�y house or lwilding for which the application is made,the owner or corrtractor shall be required to obtatn a permit for such connection,and shall pay a permit fee as provtded in Chapter 11 of this Code. After such connection has been rr�ade,the Water and Sewer Departmerrt shail be notified. It shali be unlawl'vl to cover any connecting 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 connedion. 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 properly line or a water senrice kad has been extended to the property line for connection,the appiicant,owner,or occupant or user of such premises shall be Itable fo�all repairs required to any water line and sewer lines necessary for connection of the premises from the maln 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 mai�enance and/or repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. It shali be the responsibillty of the applicant, owner,occupant or user to pe�form 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 and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)