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Meter Swap s - Request Number: 15677 Public Works Division Service Request Problem Address: 321 Hugo St Requested By: Patricia Poss Departmeat: WA1ER Address: No address provided :� Problem/Issue: INSTALL AMR METER Phone Number: �63-786-9478 �� � Scheduled Date: 2017-06-OS Schednled Tlme: 08:00:00 --1 I�YI� ' a �-�, ACTION NEEDED: ,.� � �ya. Created by: Beth Kondrick Date Grexted: 2017-OS-31 ' ACTION TAKEN: ._._.—__�._•..�%"."'_�J_..._......���.____.__.._._ ...�....__.._.._._ ._ ..__. _.. .._.._.....___........................._._.__..�...__......._._._........_.__ __._.__.___.._._._.._.___..._.__..._._._._......_.._. _..�..... Status: In Progress Submitter Has Been (.. Contacted Date Completed: Compieted by: �_ .Jr, � 7 `��' ��-- � �i#�of Fa�dtey � �O ��O� � � Water Depaxtsv�ea�t �%� � � � 6431 l�niversity Asrenue NE v Fradleyo MN 55432 �� (��� Zj 763-572-3566 � 1/we hereby authorize the C'".+ty of Fridtey and/or its empfoyees to do what is eecessary to repiace the water meter. 1 understand that the�roperty owner is liabte for the water line fram the main to the premise and ali irrterior p{urnbing. (Per t'rty code 802.06) 1 also hold the City of Fridley and/its employees harmless for arry damages Chat may occvr while doing this operation. Th�s to incfude,but not lim'rted to valves,piping,walls,floors or the curb stop box and senrice line. In understand!am aiso requt� to abtain a permit priof to any worh,'rf necessary. FBNA!METER READIAIG(old meter) ���� F�D Name•_`(1�,�'t� `� Address_�� �� � Phone Number �"� � {/ p�. �� �i C� �Signature ������� o`�/ YV'�tr►ess5ignature OLD METER# "t�� L��'vv I O OlD READiNG � � �� �� � NEW METER# ��22 �o`�.-3 3 NEW READtNC3 � ��-# �? 22Z '1 � �{ � ; FRIDLEY CITY CODE CHAPI'ER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION � (Ref Ord No 113,464,565,565,629,638,562,922,988,1144,13.56,I191j 402.5 PERMiT FEE Prior to constructing or repair of any water of sewer line cannecting the existing municipat system and arry house or bui{ding for which the application is made,the owner or contractor shall be required to obtain a permit for such�nnection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified, It shalt be untawful te cover any connecting line until an inspeckion has been made and such connection and the wortc incident thereto f�as been approved by the Gty as a proper and suitable connection. 402.06 REPAlRS AND MAIMTENAPICE TO CONPIECTION After the initfal connectio�has been made to the water service curb stop box or the sewer lead at the property line or a water serv(ce lead has been extended#o the property 11ne for connect(on,the apptiprrt,owner,or occuparit or user of wch premises shall be liable for aU repairs required to any water line and sewer tines necessary for connection aE the premises from the main to the premises. if the property owner requests maintenance service ar repairs be performed by the�ty,the property owner shall be charged for the c�ts of the mairrtenartce andJor repairs,including necessary street repairs at a rate set annuaily!ry an administrative policy. Itshall be the cesponsibi{'sty aFthe applicar�t, owner,occupan#or user to perform standard mairrtenance of the sewer service line from the premises to the main induding debris ctearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensure tfrat i#remains above#he finished grade af the las+d or property. (Ref 638,1156,1191) Request for Service Repart ' Gity of Fridley Reference No: 601-11-3171 Date: 07J01111 Requesk Type: Turn water oFFfon Entered By: Wendy Hiatt Department: Water Citizen Name: Josh-Mr. Fiooter Address_ 321 HUGO ST NE Callback Phone: - - Scheduled Date: 07I01t11 1:00 PM Property Owner: Patricia Poss Location Details: Permit#201 1-01 1 49 Request Details= Shut water oFflleave key `x"B I LL"" Action Taken: � ` - ------- i 5 I�.� � �,�,�.���` o �-� �.� c ��b 5���.. � i I �e� � �� ��, � �I or�e ou- ��r� � :� �C�.� � p � � � � ' �Q � _ �_ �� � � � Responsible Person: �---- Approver: � Complekion Date: � - � �Citizen Notified �____7 � _l/ _ _ _ _..._ ....._ ... . � � City of Fridley Water Department 6431 Universiiy Avenue NE Fridley MN 55432 (763) 572-3561 I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to shut off the water at the curb stop box. I understarid that the property owner is liable for the water line from the mai_n 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 li_mited 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: Adclress: Phone Number: Date: Signature: Wi�zess Signature: C� //�l''��� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADIVIINISTRATION (Ref Ord No 113,464,565,566,629,63 8, 662,922,988, 1144, 1156, 1191) 402.05. PERMI'i'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,the owner or contractor shall be required to obtam a permit for such cannection,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 svitable 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 line 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 property 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 tha 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 ens�e that it remains above the finished grade ofthe land or property: (Ref b38, 1156, 1191)