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Meter Swap ` Request Number: 13548 Public works Division Service Request Problem flddress: 1320 69th Ave Requested By: Carol Ward Department: WATER Aaddress: No address pcovided Problem/tasue: 1NSTAI,L AMR METER Phone ATnmber: 763-913-842� Sc6ednled Date: 2017-03-06 Schednled Time: 11:00:00 � t ACTION NEEDED: C4tieated by: Wendy Hiatt Date Created: 201?-02-1? ACTION TAKEN: �s� f � Cz--- _ � �.� _____..__ � fi.. ` � Submitter Has Been � c��.<�� Status: In Progress Contacted � �y Ihte Completed: �..� .�� Completed by: ��c I� �� • 6431�ln6v��sdty A�rer��ee DI� FrQdle�g 61r�4V 5�4,32 763-572-3556 ` p�'A°� her�by authorize the�ity�f Frndley and/or its empioyees to slo what is necessary t z. repiace#he wa�er metec, 1 Understand Nzat�he property owner�s liable for the serater line from the asiain to the premise and aN iorterior pturxtising. (Per City so�e 4A2.05� i alsa hoid ihe City trf ErBdley andJ'r�.s em�aloyees harmiess�or any�Iamages that rnay�ccur while doing thi opee�a'tion. Tiais to snctude,bu$nrnt lia�e��ted ia ya{ves,piping,watls,floors or the curb stov k�oz snd service�ine. in understand i am elso requ #o of�tain a perm'rt�rio�r to any w�r4c,if necessary. � �� S FiNAl.iFAETER READING�otd meter} � , �✓ V`� Hame• `�''� � ��/��'w,�� Address-- l�J� �.fJ 1 .�"�i Phone Number��` �l� ' v�� ate ,J s � � �� Signatur+e N!'stness S"�gnature —� f�� i ��(4�-- � ocn�w�-�R�_ � 2-- � � � 0 oLD��►D��G�a ( �7 58 a �� , h NEW ME'a"ER#_ ` q�10 +F l�� '1� � NEW REA.Dl1VG v �R�� 7 I�c�O�`� � . FRI�LEY CITY CODE CHAP't'ER Q�Q2.WATER,STORM WATER AND SANITARY SE1A/ER ADMI4YISTRA'f10N {Ref Ord No 123,464,565,�66,629,638,662,922,988,i1�4,i156,1191) 4A2.5 PERMIT FEE Prior to constructieig or repair af ar�y wate�of sewer tine connecting the exis�lartg snunicipai system and arry Ptvuse or bui(dir�fv�whidt the appiication is made,the otvner or corrtractor sFraii be requtced to obtain a permit for such connection,and shall pay a permst fee as provided ii thapter 11 of this Code. q,fter such connection has been made,the Water and Sewer Departmerrt shali be natified. iC st�ai!he untawful to cov any connecTing tine uat's1 an inspection has 6een made and such connection and#he worfc inaderrt thereto has been appraded by the G�Cy as a proper and suitable connection. 402.U5 REPAfRS AAtp�tAttltTENAAICE TD CONNECTfaN After the initiat connection has been made fio the water service curb stop Iwx or the sewer fead at Che property iine or a water servke ieact has been exfiended to the property line{or connecCion,fihe appiicarrt,owner,or accupan#oc user oF such premises shalt be liabte for a11 re�tatrs required�o arrg water I�ne and sewer Itnes necessary for connection of the premises from the main to the premis�s. if the property owner requests mairrtenance senrice or repairs be perfarmed 6y the C'rty,the property owner shaii be ctiarged for the ws#s of the mairrtenance andJo repairs,including necessary str�et repairs at a rate set annuaity by an administraitive paiicy. (t sha(t be ti�e responsihii'�ty oFthe appGcarft, owner,occupant vr user to perform standard atwirrtenance of the sewer service line from fihe premises to the main ar�duding debrkr cteartng or root cuttang and to ma�ntain the water service+curb sfiog bax for operabiiity and at such heighC as wifl ensure Chat it remair�s aboae the finished grade of the la�d or property. (Ref 638,1,156,1191j _ ��- 5-�st�S-5?sl�o�/ '� INSTALLATION "l U7YOF :;,s::, . .�.. ..�ri �.,-� � FRIDLEY Address 1 �� FJ��`� ►vame f�`��Y ��`'� Date �( t7' �, Old Meter Number 1 ��G7� r'J� Oid Meter Readi � 3� Repfacement Na �� o� Replacement Reading � Replacement Make �F��C�. Remarks: (�� 1�'C�""2 Signed: � � � � � � � � � � � � � � � � � � � � � � � � � � � � � ; � � � � � � , � � � � � � � � � � � � � � � � � � , � � ; � , ; � � ; � � � � � � � � � � t � � � � � � � � �- � � �' � � � � � � � � ; � ; � � � � � ; ��' � { , � � �� ` i� �'' � [ -� � � � � o � � � � r t i � � 3 � � t � € 7 � Q�r � � � � �� I � � � � � �r� � � � ,- � j --� ; _� _ E , � � � ; ' �� [ i �+ � � � �. � � � � � j , i 1 � � ��gg ` ? G� : � -a :�: � a Request for Ser�iee Report � . City of Fridley Reference No: 601-11-3112 Date: 06/13111 Request Type= Turn waker afflon Entered By: Wendy Hiatt Department: Water Citizen Name: Larry Reese Address= 1320 69TH AVE NE Callback Phone: 763-274-9422 Scheduled Date= 06I15111 8_00 AM � • Property Owner: � 11� � Location Details: Permit# � ��1 Request Details= Shut water oFfllearre key ""B I LL'"'" Action Taken: _..__.. _.�— �.._....._..___ _�___ . �.......�._�........___—___� �_ m_..._..___ � �c�Cl��.� 5`�'C��1�L�� i-''� S�sr ��1= ��T�.� � � �_.._�.�` ��M,r,�xi ��s(,� `T�� A��►� � ?" t�ti N� i ��-l.� ��,�-�.-� ��a� . Ar� , � �� -�: �..�� u�� Mr'��'2 � i�S��-., ' � � � ��.� ��— c��,z� � s� c��v 12�-�o�Nc.�— ��l aLl � 3c� � ,��-� ^��:--T�� -�-- ��4��lC'� ,N� ?�� ie�G — C� Responsible Person: , ��-- � L� Approver: Completion Date: � � �itizen Notified ; �� 1 �P l�___-___ �� , City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe hereby authorize the City of Fridley and/or its employees to do what is necessary to shut off the water at the curb stop box. I understarid that the property owner is liable for the water line from the ma.in to the premise. (Per City code 402.06) I also hold the Ciiy of Fridley and/or its employees harmless for any damages that may occur while doing this operation. This to include, but not limited to, sod, yard, landscaping, trees, shrubs, driveways, sidewalks or the curb stop box and service line. I understand I a.m also required to obtain a permit prior to any work. Name: Address: � 7�' 6�� C7 Phone Number: Date: �") �J"1 Signature: � Witness Signature: �. FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SATTITARY SEWER ADMIlVISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191) 402.05. PERMIT FEE Prior to constructing or repair of any water ar sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shall be required to obtam a permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. Af�er such connecrion has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an inspecrion has been made and such connection and the wark incident thereto has been approved by the City as a proper and suitable connection. ___ 402.OG. 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 line or a water service or sewer lead has been e�ended to the property li.ne for connection,the applicant, owner, or the occupant or user of such premises shall be liable for all repairs required to any water line and any sewer lines necessary for conneciion of the premises from the main to the premises. If the property owner requests maintenance services or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or repairs,including any necessary street repairs,at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of the sewer service line fram the premises to the main including debris clearing 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, 1156, 1191j