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Meter Swap Request Number: 15766 Public Works Division Service Request Problem Address: 521 Dover St Requested By: Leo Department: WATER Address: No address provided Problemfissue: INSTALL AMR METER Phone Number: 763-784-4232 Scheduled 2017-06-08 5c6eduled 1lme: 10:00:00 ACITON NEEDED: Created by: Wendy Hiatt Date Created: 2017-06-OS AC"IYON T.AI�N: _..�/_��1 ��._...W_..�..._._.__. ...� _._......_.._....._.___.._ Status: In F'rogress Sabmitter Hns Been r � Contacted Date Completed: Completed by: So-�-- l� �Ta, �Or' `� - �i�y��r6d6�y �7j��d��V ^ �� w'ater De�arterser�t t� 6431 l�niversity Averoue NE ��i /(�� Fr6dtey,MN 55432 �� 7fi3-572-356� �I°Ne herebq authorize the Crty of�ridtey and/or its emptoyees to do what is necessary to replace the water meter. t understand tfiat the pro�erty owner is tiabfe tor the water line from#he main to the premise and a!{irrterior piumbing. (Per City code 40Z.06t 1 also hotd the Giy of Fridiey and�ts emptoyees harmless for arty damages that snay occur while doing this operafion. This to indude,but nnt limited to vaives,pipin�,waUs,floors or the curb stop box and service line. in understand 1 am aiso requi� to obtain a permit prior to arry�rork,if necessary. FINAL METER READiNC,(old meterJ �� O ,'� Name: (Q� � (�1 Q6lr'e�C �� Address Phone9Yumber l E��'��ciJ"\' V i �nate 1�-�f � �� ignature �� L�'`rl Witness Signature \ _�� OLD t1IdETER# � � �� ` �V�' --'�� `fj�3 �`"' �' OLD REAL?tNG v �� v !� N��►��R#__'��12��'Z�' AtEW READING V E�# ��12�� `��2� ��u��r cirr cooE CHARTER 402.WATER,SfORM WATER AND SAPlITARY SEWER ADMlNISTRATfON , (�tef fJrd No 113,454,565,566,629,638,662,922,988,1144,1156,1191) 4Q2.5 PERf4fi"t'FEE Prior to canstructing or repair of any water of sewer iine connecting the existing municipal system and any house ar building for which the appiication is made,the owner ar oormactor shafl tie required to obtairt a permit for such connection,and shai!pay a permit fee as provided in Chapter 11 af this Code. After such connection has been made,the Water and Sewer Departmerrt sha41 be nat�fieci. it shaii be u�lawfu!to cover anY connecting line until an inspection has been made and such connection and the wosk incident thereto has been approved by Lhe City as a �roper and suitable connectiort. 402.06 REPAIRS AND MAIPITEWANCE TO CONNECTION After the initiat connection has been made to Che water service curb stop box or the sewer lead at the property line oc a water senrice lead has been extended to the property tine for connection,the applicarrt,owner,or occuparrt or user of suc�premises sh�f{be iiabie for all repairs required to any water line and sewer iines necessary for connection af the premises from the main to the premises. if the property owne� requests mairrtenance service or repairs be yzerformed by the City,the property owner shaH be charged for the c�sts of the mairrtenance and/oe repairs,inc(uding necessary street repairs at a rate set annuaily by an administrative poiicy. It shall be the responsibility of the applicartt, owner,occupant or user to perForm standard mairrtenance of the sewer service line fram the premises to the main induding debris dearing or root cutCing and to mairitain the water secvice curb stop box for operability and at such height as wiil ensure that it remains above tfy�fi'nished grade af the iand or property. {Ref 538,1156,1191) Req uest N u m ber: 6047 Public Works Division Service Request Problem Address: 521 Dover Requested By: Leo Caroon Department: WATER Address: No address provided Problem/Issue: TURN WATER ON/OFF(WATER) Phone Number. • Scheduled Date: 2013-04-23 Scheduled Time: 11:30:00 `�I UeS l '�{`� - � ` ACTION NEEDED: Turn off water for repair. Permit#2013-00651 "`"""`BILL*""* _� Created by: Wendy Hiatt Date Created: 2013-04-23 ACTION TAKEN: ..............................�...o.....�_�:�.................�..r�...�...........................�.��+................_...................�.:�-:�......................._a.�................................._C_�_%._b...._:.._._`��- 1�0.�'l.�Q,:...................Q._4�r�.t�'`".............................�,✓Q._5.............,......... ._a..._�._�....�'�'............................._�a.....................__?.`.....x............:......_4..ea`................_._........._d._� � ....�Q...J..��`'.�:a....�..:........_�..............._��`._��..............._�..�:�_.c.......�L..................._�a.�.�.................._�,,,,w��........_�....'.....`....`..`......_°_�......_........._................. < � ��y� ` ..........................._. D�'........... ............................... ........................�............................................................__.......__...__________...................... ....................................__........................................._..............................._..._.__. ..................................... . ......................................................................................................................................................................................................._......................................................................................................................................._.............................._.............................._....... ........................................................................................................................................................................................................................................................................................................................................................................................................................ Status: In Progress Resident Contacted D Date Completed: Completed by: Pe rm it No. : U��N�N�� N��N�� . CITY OF FRIDLEY * Z 0 1 3„ = 0 0 6 5 1 * , DATE ISSUED: 04/23/2013 ' 6431 UNIVERSITY AVENUE NE �--= FRIDLEY, MN 55432 763 572-3604 FAX: 763 502-4977 ADDRESS : 521 DOVER ST NE PIN : Q33024320017 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE ; PLUMBING-FIXTURE BASED PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : VALVE REPLACEMENT NOTE: CALL 763-572-3566 TO SCHEDULE SHUT OFF. CALL�FOR FIIVAL INSPECTION WITHIN 10 WORKING DAYS. REPAIR LEAK IN COPPER LINE APPLICANT VALVE REPL FEE, RESI 35.00 CAROON LEO I�&LUELLA STATE SURCHARGE,PLBG FLAT 5.00 521 DOVER ST NE TOTAL 4U.00 FRIDLEY,MN 55432 PAID WTTH CHECK# 13209 OWNER CAROON LEO H&LUELLA L 521 DOVER ST NE < �`� FRIDLEY,MN 55432 ti AGREEMENT AND SWORN STATEMENT This permit becomes nult and void if work or construction authorized is not commenced witin l 8Q days or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority ta violate or cancel the provisions of any other state or local law regulating construction or the performance of consh-uction. Applicant Date Bld Ins Date �` SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.