Meter Swap � Request Numbe . 4500
Public Works Division -
Service Request
Problem Address: 5206 Pierce St Requested By: Don Fulcher
Deputment: WA1ER Address: No address provided
ProblemlTssue: 'IURN WATER ONIOFF Phone Number: 612-991-0111
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5chednied Dxte: 201?-04-OS Scheddad 11me: 11:00:00
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ACTiON NEEDED:11�rn off weter so valv�e can be replaced and i�tall AMR
Created by: Wendy Hiatt Date Created: 201?-04-04
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ACIION TAKEN: �
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Status: In Progress Submitter Hsis Beed �
Coats�cted
Date Compteted: Completed by:
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City of Fridiey $r���
Water Department �� �"'� J�,
6431 University Avenue NE Q��. 'IJ?�a2.
Fridley,MN 55432 J✓
763-572-3566
�/We hereby authorize the City of Fridfey andJor its employees to do what is necessary to
replace the water meter. !understand that the property owner is liable for the water line from the main to the premise and aif interior
plumbing. {Per City code 402.06y i aiso hold the City of Fridfey andjits employees harmless for arry damages that may occur while doing this
operation. This to inciude,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior ta any work,if necessary.
FINAL METER READING(oid meterj
Name: Address ✓��-!J�n r�L'���
Phone Number Date 'I���
Signature Witness Signature
OLD METER#��O ��7� �
t3LD READlNG ��� ���
NEW METER# �� `v � D��
NEW READING �
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ERT# � � 7181662
FRIDLEY CIT1(CODE
CHAPTER 40Z.WATER,STORM WA7ER D SANITARY SEWER
ADMINiSTRATION
(Ref Ord No 113,464,565,566,629,638,662,92Z, 88,1144,1156,1191)
402.5 PERMIT FEE
Prior Co constructing or repair of arry water of sewer line connecting the existing municipal system and any house or buifding fo�which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and sh 1 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 not' . ft shall be uniawful to wver
any connecting line until an inspectio�has been made and sucfi connection and the work incident thereto has be approved by the City as a
proper and suitabie connection.
402.06 REPAIRS APID MAINTENANCE TO CONNECTIOAI
After the initiai connectio�has been made to tfie water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicatrt,owner,or occupant or user of wch premises shaN be liabie for all repairs
required to any water line and sewer lines necessary 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 shalf be charged for the costs of the mairrtenance andjor
repairs,including necessary street repatrs at e rate set annuaily by an administrative policy. It shall be the responsibility of the appliqnt,
owner,occupaM ar user to perform standard maintenance of the sewer service line from the premises to the main 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 fiinished
grade of the land or property. (Ref 638,1156,1191)
Request Number: 7650
Public Works Division
Service Request
Problem Address: 5206 Pierce St Requested By: �ather Nelson(house sitting for
owner)
Department: WATER A�ddress: No address provided
Problemllssue: FRO�N WATER SERVICE Phone Number: 651-644-7496
Scheduled Date: Scheduled Time:
ACTION NEEDED: Frozen water service.Gave her list of contractors and told her water dept would trace service
line.
Created by: Wendy Hiatt Date Created: 20140�13
ACTION TAKEN:
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Status: In Progress Residerrt Contacted ❑
Date Completecf: Complet by:
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