Meter Swap s
a Request Number: 15571
Public Works Division
Service Request
Problem Address: 130 71 1/2 Way , Requested By: Mike Moore
Departmeat: WA1ER Address: No address p�ovided
Problem/Issae: INSTALL AMR METER Phone Number: 763-571-6708
Scheduled Date: 2017-OS-26 � 5chednled 11me: 11:00:00
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ACTION NEEDED:
Created by: Beth Kondrick DAte Crented: 2017-OS-2S �
K�a,
ACTION TAI�N:
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Status: In Progress Submitter Hna Been r.
Contacted
� Date Compteted: Compl ed by:
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. �ity o#Eridley �u�✓ /�� � ��� � /
,- Water Department
6431 University Avenue NE C� � /`��" 1
Fr�dley, MN 55432 � v� �
763-572-3566
1/we hereby authorize the City af Fridtey andJor its employees to do what is necessary to
replace he water meter, t understand that the property owner is liable for the water line from the main to the premise and a!t iMerior
piumbing. {Per City code 4Q2.06) 1 also hoid the City of Fridley and/its employees harm{ess for any damages ihat may occur while doing this
operetion. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. in understand t am also required
to obtain a permit prior to any arork,if netessary.
FINAL METER READ{SVG(old meterj l� � � �dU
Name: /'l•�� 1-�"G Address �� 7���2 tn�..y
Phone Number� � �i � —(o p Date �ti/ ��e , a0/7
Signature witness Sigs�ature
- OLD METER# Q� ���.5`OFS
OLD READING � / 7 ,�57�
NEW METER# ��'f 2 2 C�e� ��'
NEUV READING �
ERT# �7�3SSQ�0
�RIDLEY CfTY CODE
CHAPTER 4U2.WATER,STORM WATER AND SAMtTARY SEWER
ADMlNISTltAT10N
(Ref Ord No 113,464,565,566,529,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to construding o�repair o�f any water of sewer iine connecting the existing municipal system and arry house or buitding for which the
appfication is made,the owner or contractor shail be required to otrtain a permit far such connection,and shali pay a permi#fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shaii be notified. it shail be unlavrcEul to co�+er
any connecting iine ur�til an inspection has been made and such con�ection and the work incident thereto has been appro�ned by the City�a
proper and suitable connection.
402.06 REPAIRS AND MAINTEPIAAPltCE TO COWAIECTIOPI
After the initiai connectioa has heen made ta the water senrice curb stop box or the sewer lead at the property line or a water service iead.has
been extended to fihe property line for connection,the appficarrt,owner,or occupant flr user of sucfi premises shalt be 1lable for all repairs
required to any water line and sewer lines necessary for conneetion af the premises from the main to the premises. tf the property awner
requests maintenance service o�repairs be perEormed by the C'�ty,the property owner shall be charged for the costs of the mairrtenartce and/or
repairs.including necessary street repairs at a rate set annualiy by an administrative policy. It shall be the responsibifity af the appiicant,
vwner,occuparrt or user to perForm standard mairrtenance of the sewer senrice I�ne from the premises to the main inciudin;debris dearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as wi{4 ensure that it remains above the finished
grade of the(and or property. (Ref 638,1156,1191)
� Request for Service Repart
Cit�r of Fridley
Peference No: 601-11-3202 Date: �7I14111
Requesk Type: Turn water oFFlon Entered By: Wendy Hiatk
Department: Water Citizen Name: Mark-Adam's On Time Plumbing
Address: 130 71 1 l2 WAY N E Callback Phone: 612-702-2913
Scheduled Date= 07119f11 7=30 AM 'TU�QS�; Property Owner: Mike Moore
Location Details: Permit#201 1-1 0057 Request Details: Shut waker oFfllearre key
""'BILL""
Action Taken:
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Responsible Person: €
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Approver: �
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Completion Date: � • �Citizen Notified
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City of Fridley
Water Department
6431 University Avenue NE .
Fridley MN 55432
(763) 572-3561
,
Uwe _� �� �/ � �'(�fU'� 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 main to the premise. (Per
City code 402.06) I also hold the City 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 am also required to obtain a permit prior to any work.
Name: Address:
Phone Number: Date:
Signature: �' ``� � Z t "-''
Witness Signature:
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANiTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,SbS,566,629,638,662,922,988, 1144, 1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or 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. After such
connection has been made,the Water and Sewer Department shall be notified. It shall be unlawfi�l to cover
any connecting]ine until an inspection has been made and such connection and the work incident thereto
has been approved by the City as a proper and s�table connection.
402.06. REPAIRS AND MAINTENANCE T�CONNECTION
After the initial connection has been made to the water service curb stop bax or the sewer lead at the
property line or a water service or sewer lead has been e�ended to the property line for connection,the
applicant, owner,or the occupant or nser of such premises shall be liable for all repairs required to any
water line and any sewer lines necessary for connection 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 administra#ive policy. It shall be the responsibility of the applicant, owner, occupant
or user to'perform standard maintenance of the sewer service line fro.m 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 ofthe land or property. (Ref 638, 1156, 1191)