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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 � �� ar� ACTION NEEDED: Created by: Beth Kondrick DAte Crented: 2017-OS-2S � K�a, ACTION TAI�N: ._�... ................. ,�-�._��,J��d................._,���___...............___._...._.......... _�... Status: In Progress Submitter Hna Been r. Contacted � Date Compteted: Compl ed by: I Ul� �6 �� � � � C/ ��.,,�'/ Y � �~ . �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: �� _______m ___..__.�_ ____.._�.�_. .._ ______.._. � � ,5�,�- �- 1n��-��' o � � �,,�-- c � r b Sf�Q ��� ���t� V✓ ' -�"�, �a h-�- C"w ti�1" / I '�t�� � G�� � t i �� -�.�"'` �7-� � � � � �-- _ Responsible Person: € I Approver: � I �-- Completion Date: � • �Citizen Notified _ C�v 1 l __��� _ _ _ ...___.__... � ' 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: -�� v��r�_=- 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)