Meter Swap �, Request Number: 14304
Public Works Division
Service Request
Problem Address: 5323 Matterhorn Circle Requested By: James Reavis
Department: WA'iER Address: No address providod
Problem/tssne: INSTALL AMR METER Phone Number: 763-516-0192
Schednled Ds�te: 2017-03-31 Sc6ednled 13me: 08:00:00
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ACIION NEEDED:
Created by: Wendy Hiatt Date Cre�ed: 2017-03-24
ACTION TAKEN: �
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Stxtua: In Progess Sabmitter Has Been r,
Contacted
Date Com�eted: �,_ 2 Iv 1� Completed by
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,. � 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 all interior
piumbing. (Per City code 402.06j I also hoid the City of Fridley and/its employees harmless for any damages that may occur while dang this
operation. This to include,but not{imited to valves,piping,wafls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit p�ior to any work,if necessary.
FINAL METER READING(old meter) �" O�� V�
Name: �U�1M�5 L�WV I�J Address_ ;� ��� �?Yh C��i�'�
Phone Number i�3� �lt�" d�R�- Date �� ��V � 6
Signature Witness Signature
OLD METER# �� �y 8��
OLD READING ��� ( ��v
NEW METER# } i ��� ✓� �
NEW READING v
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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 sys#em and a�y house or buiWiry�for whicfi the
application is made,the owner or contractor shall 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 connection has been made,the Water and Sewer Department shall be notified. It shall be unlawFul to wver
any conneding 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 property Nne or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be IiaWe for all repalrs
required to any water line and sewer lines nec�ssary for connection of the premises from the main 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 maintenance and/or
repairs,including necessary street repairs at a rate set annually by aa administrative policy. It shall be the respor�sibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the matn including debris dearing 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 638,3156,1191)
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FRIDLEY POLICE DEPARTMENT MN0020600 �CF� ❑ Pages: ❑ * 1 2 2 7 1 8 1 2 �K
0 Reporting Off'�ce s:
�' M147 OMAN,RANDI Total Value Stolen�n�,�: $0.00
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W 12I09/201212:53 AM 0053 0058 0121� Total Value Damaged��erty�: �0.00
� a est at ime ccurred: test ime rr :
Z 12/09/2012 12:50 AM 12/09/2012 12:50 AM Total Value Recovered��oveny�: $0.00
LocaUon o ns ncident: Apk: Grid:
5323 MATTERHORN CIR NE FRIDLEY, MN 55421- . 16-16
MOC Code: Classificatlon: Disposition:
� 09454 ACCIDENT•MV HR PD-MV FIXED OBJECT ASSISTED/ADVISED
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Incident Narrative 1
SYNOPSIS:
Dispatched to the location for a vehicle that hit a fire hydrant and then left the area.The vehicte was not located but
was described as a black Ford truck. No further.
W FWD TO FRIDLEY FIRE& FRIDLEY PUBUC WORKS
>
� DETAILS== _________
= Dispatch Info=
Q Remarks: 2 MINS AGO PD HIT AND RUN HIT FIRE HYDRANT ON MATTERHORN CIR '`*SUSP WAS DRIVING A
Z BLK FORD TRUCK TOOK OFF NB ON MATTERHORN DR*•SEVERE DAM TO FRONT END OF TRUCK•*THINKS
THE FIRE HYDRANT NEEDS TO BE LOOKED AT RP CLEARED DISPO CODE DU
[12/9/2012:0053) I was dispatched to 5323 Matterhom Cir NE for a hit and run crash.A black Ford truck hit a fire hydrant
in the cul-de-sac and then left northbound on Matterhom Dr.The caller, GAREN GEORGE NITZSCHKE,was the
NAME CODES. A-Adutt Arrested, AC-ArresUng Citlzen, C-Complainant, D-Dfirer, F-Famqy/Parent, G-Guardfan, J-Juvenile Arrested,
M-Merrtioned,MP-Missing Person, I-Other Irnrolved. O-Owner, P-Passeng�, PT-Perpetralor, R-Repo�tee, S-Suspect, V-Vicdm, W-Witr�ess
p� A/ . Code: Name: Alias:
�g�S;�� A R NITZSCHKE,GAREN GEORGE
Address treet, ity, tate, p: • t: ate . ce:
5313 MATTERHORN DR NE FRIDLEY, MN 55421- 6/5/1966 MALE WHITE
e�g • eg t: au or, ye a; us. , us. . ager sx:
600 250 BLUE 612-501-4186
pe� . e: Name: Alias:
—� ❑Business A V WOTRUBA,MICHAEL GEORGE
N
W ss treet, �tY� tate� t: ate o i : ce:
� 5323 MATTERHORN CfR NE FRIDLEY,MN 55421- 9i26/1952 MALE WHITE
Z eig : e�g h av o or. ye o or. om us. e: o us. el: ager e�c
505 200 GREEN
�P� AIJN: Code: Name: Alias;
❑Business
ress et, dy� te, P: . ate o i . .
e�g t: e�g t aur o or. ye or: om us. e: us. e : ax:
upervisor. Extra Copy To: R ated Ca� mber:
FRIDLEY PUBLIC WORKSfFRIDLEY FIRE DEPT
Page 1 of 2
• , � Narrative 1 Continuation: Page 1 of 1
, Case Number:�12271812'�Author�
eighbor who provided information.
arrived and observed the fire hydrant knocked off the secured base in fron�of the location. The tire tracks indicate the vehicle was
aveling too fast for the snowy/icy conditions and slide into the hydrant and nicked the mail box for the address also.
�ollowed the vehicle tracks from the location to NB Matterhorn Dr.The vehicle turned WB Hillwind Rd and came to the stop sign
tersection of Hillwind Rd a�d Hackmann Av.The vehicle turned WB at the intersection and entered onto Central Ave NE. I was
iable to continue to follow the tracks due to traffic in the area.
�ttempted contact with the resident of 5323 Matterhorn Cir NE where the mail box had been nicked but was still upright and relatively
idamaged. No one answered the door. I observed a vehicle in the driveway belonging to MICHAEL GEORGE WOTRUBA.
ook pictures of the damage.There were no vehicle parts located at the scene. I spoke with some neighbors i�the cul de sac who
ivised that no one in the cul-de-sac drives a black Ford pick up. But they advised it is not uncommon for unknown people to'whip'
wghnuts in the area.
ie pictures were downloaded at FPD.
ND TO FRIDLEY PUBLIC WORKS& FRIDLEY FIRE DEPT.