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Request Number: 13617
Public works Division
Service Request
Problem A�ress: 1250 Gardena Ave Requested By: Todd Halwrsen
Departmeaf: WATER Addresc: No addtess provided
Problem/Ias�: INSTALL AMR ME'IER P�one Namber: 571-0907
Scheduled e: 2017-02-2? Sci�daled 11me: 08:30:00
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AC'�N NEEDED:
Created by: Wendy Hiatt Date Created: 2017-02-23
ACIION TAI�EN:
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Status: In Progress Snbmitter H�Been �,
Co�acted
Date Compieted: Completed by:
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J �/�°� here6y authorize the�ifiy�f Frit(ley andJvr 3ts esnpioqees to sio what os necessaey
�egn9�ce the water�neter. 1 c�nderstand td�at the�ra�aexty oavner 3s liable for the avater line from the anain to��te gcemsse and aii irrterior
{�taarra9sing. ���er�Liiy�os9e d�2.a6� 1 edso hoid the�'rty�f Fe�idley andJ'fis em{stoyees haamless for arry�lamages that may�ccur rrhi(e sloir�g t
o�ea�tion. �"his#o lnclude,�u$reot lean6teei io e�alves,piPin$,uralis,�7ovrs or tfiae curb sto�s box$nd service iine. !n�xa�c(ee�and 1 am als,o s�ec
to ofatain a peranit prao�r ta asuy wor�C,�f aeecessaey.
�tiva��tETER READlt�tc(ods{meter) � �_ t � /� O �
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Name• \d� �G���dress �Z J� U1 �Q�
Phone cYumber�� ��' ��� Dace (/��� r�
Signature
Wtiness Sigs�ature
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�p+t�'EE��tD2•WAT�tt,STOR11i!WATEI�AND S,R,ANITARY SEWER
ti`"� �- ADN1tA1iS'�RAT90'N
;Rt0 i33,�64y 565,56Fi,629,635,�62,922,988,1144,I15G,1191}
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PrioP ���er of sewer lirae connectsng the euisting munici 1 em and a hause or buitdi for
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applic�ion is anade,the owner ar corrtractor shali be required to obtain a permit for si,tcft cbnnection,and s(aalf pay a permit fee as prrnrided
Chapter 11 af ihis Code. After sucf�connecCion has�een made,the dltater and Sewer Departmerrt shald be rto�ifted. tt shai{be uniawful to co
ar�y conrrecting tine urr�il an ir�spection has been anade and such connecfiiors and the worgc inciderrt fihereto has beea appro�ed by#he C�t.y as�
proper and suitable connectiore.
402.05 REPAlRS AMD�l[Al9IlTEAtANCE TQ CUN1�iECTfON
After the inifiial wnnection has been made to the wa�er service curb stop 6�vx csr Ci�e sewer fead at the Property line or a water senrice�ead�
been exfiended to tFse properCy line for connect.ian,the appticarrt,owner,or accuparrt or user of such premises shatf be liabie forall repa�rs
required to any water line end sewer lines necessary for connection of the premises from the main to the premises. If the property oarner
requests maintenance service or repairs be perFormed by the City,the properr�Lyy ownes shati be cf�arged for the�sts o€#he mairttenance and/
repairs,inctuding necessary street repairs at a rate set annuaiiy by an administrakive poiicy, ft s[�alt he ti�e responsbitity vf the appiic�
owner,occupar�#or user to perform standard mairrtenance of the sewer service line from fihe premises ta the main aacludirig dehcis clearing w
root cutting and to maicitain the water service,curb stop box for upera6itity and at such height as wiii ensure that it remair�s above the flnishe�
grade c�f the land or property. {Ref 638,1156,1191�