Meter Swap ,
` Request Number: 16215
Puhlic works Division
Service Request
Problem Address: 15�?6th Way Requested By: Jill Iohnson
Department: WATER Address: No address p�ovided
Problem/Lesue: INSTALL AMR METER Phone Number: 763-571-8185
Scheduled 'i 201 -0 -OS � �6eduled 11me: 07:00:00
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ACIION NEEl�ED:
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Created by: � Wendy Hiatt Date Cre�ted: 201?-Ob-30
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ACITON TAI�N: I
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5tatus: I�In Progress 5nbmitter Has Been �..
i Contacted
Date Completed: �/�1�, Completed by: �,��,� �r�i��n�n.�y
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�i�y o#�rid[ey � �� #- ��/�
� Water Department �"���Q�,
6431 UniversityAvenue NE
Fridley,MN 55432
753-572-3566
i/we � � I ereby authorize the City af Fridley and/or its empioyees to do what is necessary to
replace the w er meter. 1 understand that the property owner is liable foc the water line from the main to the premise and ail interior
plumbing. (Per C�ty code 402.06) I also hold the City of Fridley andjits empioyees harmless for any damages that may octivr while doing this
operatian. This to include,but not timited to vaives,piping,walis,floors or the curb stop box and service line. in undersfiand i am also required
to obtain a permit prior to any worfc,if necessary.
F1NAL METER READING(old mete�j (��� � ��
Name: Address l �� � � �� V"�
Phone Number p�,
Signature Witness Signature
OLD METER# �������g
OLD READING 8q� �� –T-------
NIIINaII�I�NI�Nllallll ��
�l
tiEw nnE-rER# 49226056
NEW READfNG — C� _ _ _ _
ERT# IIIIIIIIIIIIIIIIIIIIII E
11 72356776
FRlDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AWD SANITARY SEWER
ADMINISI'RATfON
(Ref Ord No 113,464,565,566,629,638,652,422,988,1144,1156,1191)
A02.5 PERMIT FEE
Pcior to constructing or repair of any water of sewer line connecting the existing rnunicipal system and any house or bui(ding for which the
application ts made,the owner or coritractor shali be required to obtain a permit for such connection,and sfiait pay a permit fiee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be ooiified. tt shail be unlawfui ta cover
any connecting line unti{an inspection has been made and such connectivn and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AIYD MAtNTENANCE TO COPINECTION
After the initiai connection has been made to the water sesvice curb stop box or the sewer lead at the property tine or a water serv&s tead fias
been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shail be liable for afl repairs
required to any water line and sewer lines necessary#or connection af the premises from the main to the premises. If the property owner
requests maintenance service or repairs be perf'ormed by the Ctty,the qroperty owner sha0 be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poitry. It shall be the responsibility of the app{icaM,
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 wil!ensu�e that it remains above the finished
grade af the fand or property. (Ref 638,1156,1191j
Request for Service Repart
Ci#y of Fridley
R eference N o: 601-11-3215 Date: 07/20111
Requesk Type= Turn waker oFFfan Entered By: Wendy Hiatt
Department: Water Citizen Name: Ben Franklin Plumbing
Address= 157 76TH WAY NE Callback Phone:
Scheduled Date= Property Owner:
Location Details: Permit# Request Details= Shut water oFF
%xx`B I LL"'x
Action Taken:
Jason on call. Came in to shuk off water.� � ��
Jason Wiehle
Fiesponsible Person:
��-- _
�ryJorgensen � �
Approver:
+�' Citizen Notified
Completion Date: 07119111 6:43 AM �