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Meter Swap .. � � Request Number: 13689 Public Works Division Service Request Problem Address: 1359 76th Are Requested By: Cheryl Department: WATER Address: 1359 76th Arc Ftidley,MN 55432 Problem/Isaue: INSTALL AMR METER Phane Number: 414975-1240 SchednledDat • 2017-03-25 Schednled'llme: 11:30:00 d a S�� ' 3 ACTiON NEEDED: C�ated by: Beth Kondrick DAte Created: 2017-02-2'1 ACIION TAKEN: _ ��.� _....._._......_..._�� a ; ...w...�.........._.......�.. . . �M.7. rl.:':' Status: 1n Progress Submitter Hns Been � Contacted Date Compieted: i�,_ 1 C,_ I Completed by: ` �� O� '�'r��`. J (/`cJ � �J�t"`� •#�� , �� 32,d�nav�rsitg/e\vero�ae 6V� �rodle�,61�1�i 55432 753-s72-3 s6� . � �/'"°� her�by euthorize the Ciiy o#Fridley anclJor its empioyses to aio what is necessary t replece#he water rneter, t vnderstand ti�+at�he�rogerty owner 9s liable for the watee line from the main to the premise and ail irnerior ' {�lurrrbing. (Per Crty sode$II2.06� !alsu hotd the C"+ty�f fcidie�andJ'rts empioyees harmless for any damages thai may otcur white sloing thi opera'tian. This#o tnclude,but not 8imi#ed to valves,p9pirog,wa!(s,fl�ors or the curb stop�oz ared service line. In understand 1 am also requ to oi�taira a permit pnor to any ierorlc,if necessaey. �� ._ �� z� �� C�� E9NA1-1VIETER READING{old meterj � � a-�D �-� ��( � Name• �`P r'`/ ' Jk(dre�s_��v � ��Y ��►° Phone lYumber ��-! " ! ��pate ✓"��'" 4� �ignature � �� IAt�tness Signature oLo M�-�R�_ ��8 �� ( � Sv�v�� l(� `� otD��a��G l8� �� `� - NEW MEtER# � � v l�J�J l0 $ NE1N REAattVG � ERT#_ _ � l � � 1 J� � . • FRID[�Y�ITV CODE , CHAPT'Eti 402.WATER,STORM WATE4�Alfi[D SANiTARY SEWER ADMl1�IIS3RATION {9tef Ord No 113,4�64,565,�66,629,638,562,922,988,1144,Ii56,1191j a.axs g�r�wr�Fe� Prior#o constructing ar repair af any wafier of sewer line connecting the existing municipal system and arry house er buiidir�g for whic6 the �RP��an jS madQ,the owner or cor►tractor sha(1!�e required to obtain a permit for suc(7 connection,and shall{ray a permiC fee as provided;� Cha#�ter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shali be notified. tt sf�tt be unlawfui M cov arry coanecting line ur�til an inspection has been made and such connection and the worh inciderrt thereCo has been approved by the C'rty as a proper end suitable connection. 402.06 REPAIRS A4iD f�FiAlfliiTENAMCE TO CONWECTfON After Che initiat connectivn has been made to the water service curb stop box or the sewer lead at the property itne o�a water senrice lead has been exfiended to fi�fte property line for connedian,the appiicarrt,owner,or accuparrC or user of such premises shatt be liabte{vr al�repa�rs required�a any water line and sewer iines necessary for connection of the premises from#he main to the premises. tf the prop�rty owner reques#s mairr#enance service or repairs be performed by tf�e C'ity,the property owner shaii be charged for the costs of#he mai�rter�ance and/o repairs,inctuding necessary s�treet repairs at a ra�te set annually by an administrative policy. tt shal!be fihe respons�ility of the appl'sc.asrt, owner,occupan#or user to perform standard mairrtenance aF the sewer service line from fihe prem+ses to the nnain ancluding debns caearing or root cutting and to mairrtain#he water service curb sTop box for operability and at such height as wili ensure that it remains above the finished grade of the dand+or property. (Ref 638,1156,1191.) � 1 l � pl p��z�� ' Y� I ! :a�e��ex� ��i :�nc� :t�cas�ad�� _ _...___....________._ . ..... __.__._ ._ ._ . __ i € ' • .. �a ^1, �-�a v -� � ='�:� �} .�-,► c,� ,�„ld � � �� .� �-I- s�� 'b a� � �� )1 '•fS , ��, 7 s�"a�( � �a� a� p `�j S' 1 a.�r .•�-� �J a''^°f�! � � , ".� � a�( � �a� p�� pa� � ,�' J �.� -, 9 � �� -� � � „ J -b �- � Ja--� -�/`1 �'`'� � � G -f �_______________ _____.___ :�� s �=��o � �stz�-t Goz��d :��,�� :��a rrv a�=s t�+n�c�� a�a �� L�4'E8L-£9L �4d��'J 3Fl 3AV H19L 6�£� ��Pkt se�snea�sed�ana�{ :au�e��z� �a�/�! :}�w�da(} i��i'�M �8'F��3 '�'/�P��1 =�1 � lld)Z�'�6lIQl =��0 S'�5£-lt-l�9 :Q{��atirara� �1�� . �JOd��j �NJ� �a� �S3fl�tj . __.. _...._ ... _ - . • City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe hereby authorize the Ciiy of Fridley and/or its employees to do what is necessary to shut off the water at the curb stop box. I understand 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: ,�.... �.._..---��--� --' .�,_:--•~ � �-' � „_.....-----w' _..._-. �,.�� ,,...�.. .._ - �,,- ,,,, �. Witness Signature: �'.. ,.,..��,��✓i` � FRIDLEY CITY CODE CHAPTER 402. WATER,STORM WATER AND SANITARY SEWER ADNIINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191) 402.05. PERNIIT 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,tlie 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 unlawful to cover any connecting line 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�ritable connection. 402.06. REPAIl2S 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 li.ne or a water service or sewer lead has been e�ended to the property line 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 connection of the premises from the main to the premises. If the properly 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 from 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. (R,ef 638, 1156, 1191)