Meter Swap t-
. Request Number: 13823
Public works Division
Service Request
Problem Addresa: 1605 Woodside Ct Reqnested By: Andrew Million
Departme�: WA'IER Addresa: No address pmvided
Problem/Isa�: INSTALL AMR ME1ER Phoae Nnmber: 651-328-0639
Sche�uled Date: 2017-03-13 Sc�edal�'ifine: 01:30:00
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ACIION NEEDED:
Created by: Wendy Hiatt Date Cre�ed: 201'1-03-03
AC7ION T .
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St�tna: In Pro ss Snbmitter Ha�Been r,
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Date Completed: Completed by: ��
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���e h�r��y a�tf�orize ttae�' a#Fridl
�'ega9�ce t#�e uva�er sraeter. ��nclerstaetd t�at�he ro e '� eq aredOar�s empdoyees to sio wv�a#es ne:cess
p � �'c�l ownes�s�ia�le taa'�l�ee�+ra�ter 4ie►e�rom the anain to itae premise and all aarterio�
�afaareadsieag. (P�er�C'st+j cos9e���.06� �adso fiamid#he�'rty�Fsidley and�5ts eraa�ulmyees hasrnless�or any�Jamages thhat naay occur rr3aite aioir:
��Sea�ion_ �'9ais�o�r�efucfe,Rarxt eno�dasas�ted�o valves,P9p9ra�awatis,3loors or 3�ae aasrla stog&aox�rad servece�is�e_ Irn undeestand�am also
` t�otataira a gea•anit gar�ar to aroy�rnr�C,i��ecessare�-
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itiame:���i����� �,(�G�� Address � �� `�
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FRIDLEY C��"if Ct)DE
CF�A�EE�QOZ.V6fAT�E�,STO�Wf�1T'ER AND S�NIi'ARY SEWER
ADAI!9lIC tS9'RAT�C�11
��tef�1rcd�l0133,�i64y 565,,66,629,638,662,922,98$,11�4,ILG,1191�
4Q2.5 PERMd�"FEE '
Prior#o sonstr�ctie�g or s^epair vF any water aF seryer iirae connecting$he e�c�irsg rr�unicipat system and arry�ouse os�i(ding fo��rhich#fie
appticafiion is anade,the o�vner or corstractor shall be required to obtain a permifi for such corrrrection,and staali pa3r a permii fee as prwidF
Chaptex 1�of this Cade. After such connection has beer+made,the Yflilater and Sewer Departmerrt shatt�e�eo 't�f'ied. Pt shail he uniawfu�to
ar�y coranecting�ine unial an inspection�sas been anade and such connectian and the woric inciderrt thereto has beec�aPPraved h�tEte C"�ty a
proper and suitable cvnnectiora.
402.06 #iEPAtRS�!R{D�AlittTENASdCE TO CCD91tN�C1'fON
,4�er the tnidTal sonnection fras been made to the water servic�e aari�stvp box o��e sewer ie�t atthe property�ine vs a rraber seroice iead
been extended to tfse praperty line fvr conreedavn,the applicarrt,owner,or aecvpant ar user of such premises shaJf be 1'sa�e for ail r��tain
required to ar�g wa�ter lpne arid sewer Isnes necessary#or connection of fihe premises frorrs the main to fihe premises. tf the proper[y awner
e�equesls mairrtenance se:roice o�repairs 6e perFormed Ery the C'rty,the property awrrer shall be charged for the cosfs af the mairrCenar�an�
repairs,includirag nece$sary street repairs at a rate se�t annuaify by an adnninistra#iue poficy. it shat!be i�ae�sponsib�i'rty of the applicarrt,
awner,occu�ant or user to perform sgandard anaimeriance of i�e sewer seraice line frvm the premises to the rnain aadudirig debris dearing
root cu�tang and to mairrtain the wwater service curb stvp 6Qx for opeeai�slity and at such�eight as wiit ensure Ci�at it remairis above tfie ftnish
grade of the�and or�aroperty- (i�ef 638,1a56.1192)
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Address ��� � � � � �_ ..��:�,
Name 'S 1 �
Date � -�
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Replacement No:
Replacement Reading_ (�
Replacement Make - �
Remarks: �n�p�p ��.-�-,�
Signed
Request for Service Repart
�ity of Fridley
Reference No: 601-11-3019 Date: 05103I11
Requext Type= Turn water ofFfon Entered By: Wendy Hiatt
Department: Water Citizen Name: Shelby-Real Estate Mgmt
Address: 1605 WUOdSIDE CT NE Callback Phone: 651-770-0165
S cheduled D ate= Property 0 wner:
Location Details: Turn water on by 5I4I11 Requexk Details: Turn water on
Lockbox: 0 CN
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Action Taken:
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Responsible Person: � ✓� �„� /g��✓''e�'``'
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Approver:
Completion Date: ' / `/ � Q Citizen Notified
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