Meter Swap . '
' Request Number: 12843
Pubfic Works Division
Service Request
Problem Address: 1600 75th Are Requested By: MicY�elle Bachcr
DepartmeM: WATER A�ddress: 1600 7Sth A�
Fridley,MN SS432
Problem/Lsne: INSTALL AMR METER Phone Nnmber: 651-269-8557
Sci�eivled Date: 2017-01-26 Sc�tedaled T'ime: 08:30:00
`��v►��c � c�tie�
ACZiON NEEDED:lnstall ANIIt
Created by: Beth Kondrick Date C�reaked: 201�-01-12
ACTiON TAI�N:
l � �
St��: In Progress Sabmitter Ha�Bece �,
Coetscted
Date Completed: Completed by:
� � �� � ��l l��
"'C'o�,�.�
City of Fridley � �` "�� ��/
• Water Department � V
^ 6431 University Avenue NE
Fridley,MN 55432 �v 3 "S�'��yv ���
763-572-3566
�/We hereby authorize the City of Pridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable fo�the water line from the main to tfie premise and ali interior
plumbing. (Per City code 402.06) 1 also hotd the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This ta include,but not limited to va{ves,piping,walis,ffoors or the curb stop box and servke line. In understand I am also required
to obtain a permit prior to any work,'rf necessary.
FINAL METER READING(old meter) �� i V �Q
Name: � dress V��)V �� !��' '
Phone Number��_l�J" � ��� Date ����� 1.
Signature ��''��"�"-- Witness Signature
OLD METER# ���f,..�L.J�� `' � "� �.)
v
OLD READfNG 2�� �'V
NEW METER# ���� ����
NEW READING D
ERT# � El� � � 1 C� 1
FRiDLEY CITY CODE
CHAP7ER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipai system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connedion.and shail pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the worlc incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AAID MAINTENANCE TO CONNECTION
After the initiai connection has been made to the wate�service curb stop box or the sewer lead at the property li�e or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shatl be{iable for afl repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance service or�epairs be perfocmed by the City,tfie property owner shatf be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annuaNy by an administrative policy. It shail be the responsibility of the applicarrt,
owner,octupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintai�the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the tand or property. (Ref 638,1156,1191)
R�quest far �erdice Report
City Qf Fri�il�y
Raf�rcr�c�No: (C��- 1 Z � ���J date: � '- ��' —`��,
Rcqucxt d'ype� � ��'t����C� �1� Entetad 8y.
Oeaarkment: ��,�,!-��� Citixen Name� ��µ��,j,� ���-��
Address- ��J��`— !��♦� Callback Pfior�e: ""�/_��"���_�'°Z�..►`J
L�7 J
Scheduded{Date: Proper�y Owner.
Location De�ails; Requext [�ffitaila� ���� i� _ _,� �
,��C,l
Action Takan;
��-r� o� C�t�, - ���"� ����
�;r`c /v��� �l.��c�,
�
Fiespons�bic Person�
Ap�rovet.
..__
_.._ __ __
_.� _ _._. __----.. _.. Citizen Notified
CL7mpletion Dat�: (
� � '�..��____-_.--_-_.
��u�t f�r�r�ric� R
Ci�yr c�f F�itf�y
�3n: �-12-4�a i�e: �!`l2l�+�t2
ue�t Tj�pe� �back-s�p c�fi�r� �+'� �
��� � ��ae: �e 8r�c�r
�Add�eas: ��6i1D 7�TH/111�!� _ 763-�#1-D�
�: �
�[�a�: Ae�rat t�ta�s: �6ar�c�- Pete C�ndQaon an
+ea�i_
A�n Tai�e:
t�j► _
�
I •
�
� _ ?
,
,
i
�
- i
2
� ._ �_�_._.._._._... ...... ....................._.__......�.......w......._..._
. �1/�.{1�i�`�}�� . .
6.„_�-...._. . �....,�_ .��...�...v..a.......� �