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Request Number: 16701
Public Works Division
5ervice Request
Problem Address: 6060 Woody Lane NE Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-574-0446
Scheduled Date: �� Scheduled Time: �
�'�
ACTION NEEDED: Install AMR
Created by: Jeannie Benson Date Created: 2017-08-11
ACTION TAKEN:
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Status: In Progress Submitter Has Been r.,
Contacted
Date Completed: � ` I�� � � Completed by: `
Jak�
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���� �Sere9sy aut�oriz�the�ty a#�ridPey ae�eidor its�are�eia�ees�o dm�erFsat is�ece�sary
a-��aiac�the�rater nae-t�e, �us�st�rstae�d t�eat tl�e�r��e��own�a�as�iable for#�e water line frorra�9Se�aadra to�he�r�saeise and a1B�e�ter9or
�dum�minga {Per C'rt��code 4��.�6� �a�so ho8�1��ae��y�f�r�cNey arardJi#s empir�yees fiarrntess f�r am/daraoages�.fifia�t enay occur wlaile doing t
x��ea�t9on. "9'�sis t�ia�clwde,fae�t�aot lim+tz��o vsives.�aigsirsg�e+raits,�loors ar�e cua�s st�p ba�c and serarice 3ine_ In undersqrsd�arn also�2c
�o o�'tain a�aer�ait�sraor�o ara�w�srfc,i€necessary.
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FR�lDLEY��'�OCDE
�F�A�E��3�.�IA'�t�,S�'�FBN�WA�'E�t�ID SAN6TA1����NEtt
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� �r6or to constnuc�ing or repair�rf any bvafier of sewer line connecting the existing rnunacipai system and arty house or bu9Tding#or which C�se
a�aplication is made,the awner or�orr�raetor sha�l tse required to o6fiain a permit for such connection,and shall pay a�ermit fee as provided
�hapter 11 of this Cr�de. After such connection has been rreade,gFae�Alater and Seeaer Qepartmerrt shail be notified. !t sha(1 be vniawfu!to�x
an�connecting tine urstit an ins�aection 4�as�Seen made and such coranectian asad fihe�,rroc!c inciderrh titereto has�eert approved tay tfte�'i�ty as�
�roper and suitable connectiort.
5�02.06 REPA(RS A�iD 11f1/�iN�NANCE T'��Oi�tiUEC!'ION
k�,fter the initia#sronnection has been rrtade to ti�e�uater senrice�rb stop box Qr the sewer t�ad afi the�raperty�ine ar a u�ater service�ead h:
been extended ta i�e�rope�ty line fos cannection.the appficarrt,owner,ar occupartt�r user af sucFr premises shall be liabte for aii repairs
requia^ed to arty,nra��r 9ine and senver lines necessar�Po�connection of ithe premises from the main L^o the premises. !f the property rnaner
requests mairrtenance servics or repairs be perFortned�r the C'�ty,fihe�roperty ownsr shall be charged for the cosfis af the mairrtenance ar�d�
re�airs,in�luding rtecessary street r�pairs at a�te set annuaity�y an administrafiive poiicy. It shatl be the responsibP{"�ty of the a�aplip�rC,
owner,occupara#or user to perforrn sCandard mairrterrance o�f tdae sewer service lirte from the premises to the mairt inc(uding debris ctearirrg a
rocr*�uttirtg ar�c!fim maintain the�vater service cur6 sto�box for ope�rabitifiy and at such height as wil(ensuro that it r�emair�s abvve the finishe
grade o�f�he ianc!or pro�Oerty. �[�ef 638,��.56.119�}
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City of Fridley
Water Depar,_ tment
Address��, ��y �
Name ��4�1/1/11�� �1c�v✓lC 2�l K - --
Date I`I�e� �C��
01d Meter Number � / "l
Old Meter Reading 1
Replacement No. _
Replacement Reading �_
Replacement Make�-��.�Y�,
Remarks: , �GI/1 /�i C�
Signed ��