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Meter Swap . � Request Number: 16937 Public Works Division ��✓ ���71C� �� Service Request ��� �-��� Problem Address: 5580 E Bavazian Pass Requested By: Dastin r Departmcnt: WA'IER Addresa: No address provided Problem/Isaue: IlV5TALL AMR METER PLone Number: 651-274-5965 �� Schedule�lh�te: 2017-09-12 Schedaled'Ilme: 09:00:00 ACTION NEEDED: Created by: Wemiy Hiatt Date Cr�ated: 2017-09-08 ACITON TA[+�N: � / ��r�6 A��1�� �►'yp� �. /���- .�..�- ,�_ �9�s"s-s".� ? J /�'c"' �,�,.c� _ O _....._...__.......................__�...._____.__._..................__......_..___ _.___._.__.._............__.__............._.._._.__ ............._ -_________. --� /^<<� _ �.?y � 9,?/� ....................................�.._.___._.....................__._... . . -.-.,--�.�z o-�.�-�. - - ` O/d ,,,�„�„r � --_.._ik _�...,�_�_�� "'��1�. _.�/�._.-�.,/...�..._.-___.._�.�`�.Z�_.,._.�S/'tdlN.�_'..�_....��..�__.._.........._ ...._....__�...._\__._._..._ Status: 1n Pro�ess Subm�tter Has Been � Cont�tcted Dxte Compteted: Completed by: ��1z �� 1 � ;:�. , �a���+4`��c��#!(ea, J� 'r��'�-c•�!r fl�;r���tTmc ��r,� , �j) �i'�� � V a�:��?,J�s'+��,r�a�,�r�:�r��s���� � �f 0 ���l��e^�,���� ���� �� ��� L ���-���-���� � ��'N� her��y aaa-Nharize��(.��:��:Fridfe?9 3e�a�/�r its'rn�nd�?��es r.�,�ca svk�ts r�ecz<. rm��a��.ne�,��r�.r;v►e�*2�-, 1 ua�e���aa�a��a?��;ae�e�c��e�,�3�n�e�is fia��e tu��e�rat29'{98"!L'�Y^D�fl L'�1L'89�963",.T. i.''�S�;3P2�8'4'�2 319tj 3J{iTT�aS'9a ;�da�rnL�i��, ��;;���.,y caete��.1�6� 4 a�sca�o�+��sh�Ci�af�c34e���d,�i�ts smpiaop.=es hae�r�a@�ss fae�aaav�daasoa���'nat�a���ct�aa��ae�aii�d�o� o�ser��ion> T�6s�:s�in��a�e,isea��crfi fdrs�a�z�t��r�a�ies,t89(J9Td�'y��r�dts,�s�vss ar�e aas�a�a���aaa�f ses*�sc�lia�e, ir��a�c2errs�aac�d i�e�a ads+ ��o�air�a�ersrri��io��o ar�t����st<,if,�e�ssac^�. �S+d.�ii.�ti"'�'�d�ti�,�li�l�{a�d meter� s�as'r�e• +�dd%.53 �8 v � �,v�{�7�Q�� �� �P�Q�ne i�urn�er �� �i�rtat�ae� tM1Ji�treess S'ignattxre �� ���� _ 7�sss� �� ������ //7/800 �:�r�����_ _ y 53SS5 t� — . �,:�.. !�•- Lr�•5� I''�' ��� ����� � � � � ��r� � �� � 3��y ���������� ��;A��'t��e?��;���Q�'����,�'�ai�i t�St�,�iS��S��$� #����8�ilS'I'���R� �R�s������,�,��.�,��,���,���,���,��a�ss, ��.�,�:��,���� ��� �������� � ��iv���cor.s-t;rs�ting or rogaaic c�f am�watsr of;z+xrer[irse cor,nes:ting ci�e�cistirsg rnunac��na{syst�m arte�arsy hause ar bui(ding for�erhich# a��Odicafiior�is rs�acle,t3�e o+Rrr�es�ar corrt�sact�r sha{1�e reqaaar�d tcs o�atairs a p�rrrsit'fas�sucta ca+�r�ection,aesd�ail�ay a�es�m��ee as pr�v tha�e�-i3 of�ts C�r�e, Afi:er�ucla coa�nectfo�a�as bees��rsade,�e�lates and a"e�vec De�tae�ta3►errt shai{be na�ifified. tt st�a{i be untavvfvl ar;ry cerc�nectirag Iirae�;ra�iE an irts�e�ctior�has�ees�rnade a�rd sucfa ccsr�a�ect:or�acsd t�se,vasac incidera�t t�rer2i�rtas aeers a��rv�ed�C#se C'ifi«, �+�per and suatalade canraec*.�a�e. d��Z.d�6 R��:�JRS,�a�(���rts�84�l�dt�1���S C�RiM��'t''laflf ���iae ini�aa#��e�i:iort has�aeen rnade to i�ae�vater servic2 asrb s-�or��vx nr i�xe��rar tead��e�roper��ine ar a�r se+�rice tea �aeera�ac:2a�de�cQ�se property ti�re fvr conrtectson,htae a�aplisars�,�vner,ar Qccupant or user aF�,ech prerrtises sEtall�fial�le fvr atl re�aii s2c{ulra�'to aray�,va*er tine anr�se�aer lines ne�ssar�for cnnner.tzora of*he premfses fr3m.tse rrtain t�ttse{rr2mises. �E the prePer��a�s r�r�uesfis,�atrnenanc�;ervi+ce vr r�pairs be pe�fvrmed sy�e.�".jty,td�e proper�vwner shatl i�e ctiar�ged for cize cos�s af kf�e cttairsi�nan� re�airs,inclucta�g ne�ce�an�street repairs�t a r�te set arsc�uarly uy ars admfnistrative pQiicy. tx si�a13 6e C�se�onsibiti�ty af t#ie applica►3r, sr�rner,ac�upasxt ar user to�erf.rsrr standard mairrt2narrce rnF�ae setuer servi�(in�i�arrs ttae gr�mises tc+:fse main inducftrr�deb�is deari �'Qcr+:c�c'�s�g��d ta mairstain ti�e rnrater se��ic2 cur�a;�:csz�uQx for a�e�bidi�y and at sucfs hei�rt as��iiT ensue^a�at it romains abaye�Fae fin g�de aF�fts iasscf�r r�ro�ea�. (��;F 638,256,1391� -;— �� C5= _--___ � � � R�quest for Service Rap€�rt � � City of F�i�iiey Retercr�c�N�a: � � ', � `" � �C1� dat�: ficque�t Type� ''rv�� `�--��"`DC-t—^ Entered By. Deparkment: l��C��'� Citizen Nama �� � �� ��L��� � �"E Add�esz= 5�� � ,�/`��� ��� Cail6ack P�one: �j�l� p��]�'� S��j� Scheduted Date: � —�—\1 Pr�perly Owner. Locakion Dekails: Rcquext[Detaifa: ��.T�'(� '��}1,)'� Q�. �"' Action Taken: (�J����.'�r-N � �.��'� �l��'7 U�l—l"" � � �e�w�-3�c'� �(1 C�''t� .elJ�l C���'�S W ���'� N�-r �- �`�` a� ��� �t��z���- , �C�2� ��r ����-�2� � ��,,�--�L � �� � �� t�C�g ��Z ��O l � vcZ r.� Z� �,,p��z"���-(� 01J � �tt., ��r� ��-�'n�t 1-�Ca w� � '��.�l.� � �1-� ��� i� a � ,1�10�.��' _------ Ficsponsibie Person� Approv�r. . ._.._ _._ ._ _ ._ _.. ____ .._ -- -------- __ _. --. --- _ .ikizen�l oti6ed CLzmpletion D at�: -.._ J�� _�_-�-�-�-----. ._ .---__._: kN . �. . � ' . + � . , i City of Fric3ley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe hereby authorize the City of Fridley andlor its employees to do what is necessary to shut off the wa#er at the curb stop box. I understaad that the property owner is liable for the water line from the mai.n to the premise. (Per City code 402.06) I also hold the City of Fridley and/or its employees harmiess for any damages tliat 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 and service line. I understan I am also required to obtain a permit prior to any work. i / Name: iT��S�,�n /l(O�a � Adciress: SS�D �� ��u,� � �, �f 5 Phone Number: (j��I- Z 7 u � � 9�� Date: 7�$��( Signature: Witness Signature: �'RIDLEY CITY Cfl3DE C�3APTER 4a2.WATER,S�'ORM WATER?u�TD SAiVITARY S�WER AD1ViIl�ISTRATION (Ref Ord No 113,454,565,566, 629,638,662,922,988, 1144, 1156, 1191) 402.05. PE.RNIIT�E Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for whic�the application is made,the owner or contractor shall be required to obtavi a permit for such connection,and sha.11 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 shatl be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been agproved by the City as a proper and stritable connection_ 402.06. REPAIltS A��TD MAINTENANGE'T�CONNECTI�N After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service or sawer lead has been e;ctended to the property line for connection,the applicant, owner, or the occupant or user of such premises shall be liable for a,ll repairs required to any water line and any seRrer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance services or repairs be pezformed by the City,the property owner shall be charged for the costs of the maintenance and/or repairs,inciudi.ng any necessary street repairs,at a rate set annually by an administrative policy. It shall be the responsibility of the applicant, owner,occugant or user tQ`perform standard maintenauce of the sewer service line fro.m the premises to the main including debris clearing or root cutting and to maintain the water servic�curb stop box for operability and at such height as will ensure that it remains above the finished�a.de of the land or property: (Ref fi38, 1156, 1191j