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, � Request Number: 1 ��'
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Public Works Division
Service Request
Problem Address: 5640 N Danube Rd Requeated By: Nick Hoppe
Department: WATER Addregg: 5640 N Damibe Rd
Fridloy,MN 55433
Problem/tssue: INSTALL AMR ME1ER Phone Number: 651-328-0888
Scheduled Date: 2017-02-25 Schednled 11m�: 09:00:00
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ACIION NEEDED:
Created by: Beth Kon�ick Datc CYe�ed: 2017-01-2?
ACTION TAI�N: �
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Statu:c: In Progress Seb�atitter Hsa Been f..,
Cout�ted
Dste Completed: Completed by:
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s�axe��e�sar��a�ees�t
6431 lJniv�rsdtyr/�,ve�aate 9UE
FricffQy,lV�N 554�2 �
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. 753-572-3566 �
� �j�W� hereby authorize#he City�f Fridley and/or ats emptoyees to do what is necessary to
replace Yhe water meter. 1 understand that the proper�j oamer 3s tiabie for the water line from the main to the premise and ail irtterior
p{urrabing. (Per Crty cosie 402.06j i aise hold tt�e Cii�j of�ridley and/its empioyees haemless#or any damages that may occur while doing this
operation. This to include,buC not Bim�ted to valves,piping,waiis,floors or the curb stop k�oK and sQrvice line. fn understand�am also requir
to obtaia a permit prior to any wo+ric,if necessaey.
FIAIAL MEi'ER READI9NG(oPd meterj
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Name: � v �_ K-^ Address
Phone Alumber � Date�"�"L/_(7" ��
Signature� Witrsess Signature
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FRIDLEY Ci7Y CODE
CHAPTER 402.WATER,STORM WATER AfYD SANITARY SEINER
ADMIlYISTRATlt?N
{Ref Ord No 113,464,565,566,629,638,662,922,988,1144,i156,T19Tj
402.5 PERRdTtT FEE
Drior to constsuctiog or repair of any�rater of sexrer tine connecting the existing municapal s�pstem and arry hause or butldirrg for which the
application is macle,the owner or corrtractor s(sall be required to obtain a permit for suci�connedion,and shali pay a permit fee as provided ia
Cha�ster 11 af this Code. After such connection has been made,the Water and Sewer Departmerrt sl�aU be no�i�fied. tt shap be un(awful to cove
any connecCing(ine until an inspection has been anade and such connection and the work�naderrt thereto has been apprwed by the City as a
proper and suitabte connection.
402.05 REPA(RS AND MAIPiTEiVANCE TO COWNEC710N
AAftter�Che initiat conneccion has been mads to the water se�rtce curb sto�boK or the sQwer lead at the propecty l�ne or a waterservice�ead has
been extended to the property liae for wnredion,the applicar+t,owner,ar accupasit or user af such premises shaU be Rabie for aif repairs
required to any water(ine and sewer lines necessary#or connection of tfie premises from the main to the premises. If�the p�roperly vwner
reqaests mairrtenance service or repairs be perEormed by the Crty,the property otivner shatl be charged for the costs af the mairrtenanc�e andJor
repairs,inciuding necessary street repairs at a rate se�annualfy!�an administraitive qoficy. FC shat!be the responsibility oE tFte appficarrt,
owner,occupar�t or user tv perform standard mairrtenance af the sewes servsce line from the preroises io#he main indudir�g debrts dearing or
raot tutting and to mainCain the water service curb stop box#or operabitity and at such heigfrt�will ensure that�t remairis a6ove the fin�ed
grade af the�and or property. �Ref 638,1156,1191j