Meter Swap , Request Number: 15493
Public works Division
Service Reqt�est
Problem Address: 6972 Hickory Dr Requested By: Brian Ra�uvwrth
Department: WA1ER Address: No address provided
Problem/issue: INSTALL AMR METER Phone Nnmber: 612-810-2460
Scheduled Dat • 2017-OS-24 Schednled 13me: 01:00:00
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ACIION NEEDED:
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Created by: We�dy Hiatt Date Created: 2017-OS-22
ACTION TAI�N:
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Status: In Progress Snbmitter Has Been �.
Co�rtacted
Date Completed: Completed by:
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' City of Fridley
' Water Department �..J" � �) /' ► J
6431 University Avenue NE ��� ��
Fcidley,MN 55432
763-57Z-3566
��We hereby authorize the City of Fridley and/or its empfoyees to do what is necessary to
repiace the water meter. i understand that the property owner is liable fo�the water line from the matn to the premise and al{interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages ihat may ou.ur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and servite line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READNV6(old meter) � � � `--'� ��,J
Name:���i � ��qddress � v �
Pfione Number '�--` ` � l. �OV Date_ �� '�4`r ��
Signature Witness Signature
OLD METER#� (�l O�� �
OLD READING � c� �� - `�U
NEW METER# � 1�✓ �O��
NEW READING V
E�# � 2���"O��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATIOPI
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipal system and any house or buikiing for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connection,a�d 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 un(awful 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
propec and suitable conneCtion.
402.06 REPAlRS AND MAlNTEPIAPICE TO COAiMEC�'ION
After the initiai connection has been made to tfie water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shall be liable for all 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 maiote�ance service or repairs be performed by the City,the property owner shaii be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service wrb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
Request Number: 7911
Public Works Division
Service Request
Problem Address: 6972 Hickory Dr Requested By: Police Dispatch
Department: WATER �dress: No address provided
Problemllssue: WATER MAIN BREAK Phone Number:
Scheduled Date: Schedu{ed Time:
ACl'�N NEEDED: Possible water main break at Hickory Dr and Hickory Circle
Created by: Wendy Hiatt Date Created: 201405-20
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: � � ��/ � Completed by: ��' g�e� �`
Haurs � ��