Meter Swap n
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Request Number: 15892
Public Works Division
Service Request
Problem Address: 19Q Ironton St Requested By: Jill Koehler
Department: WATER Address: No address provided
ProbleauiIssue: INSTALI,t1MR METER Phone Number: 763-772-3928
Scheduled Date: 2017-06-15 Schednled TSme: 10:30:00
1 :
ACTTON NEEDED:
Created by: Bcth Kondrick Date Created: 2017-06-08
ACTION T.�I�N:
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5tatus: In Progress Submitter Haa Been r
Contacted
Date Completed: Completed by:
�O� [�'— ,� `��'f�b`�
t �ity of Fridley �i ��— �j���p� � ��
� Water Department
6431 University Avenue NE � „L� �j Cj Q
Fridley,MN 55432 '�-�--•- CJ �/Q
7fi3-572-3566
1/we hereby autharize the City of Pridley andjor its employees to do what is necessary to
repface the water meter. i understand that the property owner is liable for the water line ftom the enain to the premise and a)i iMerior
plumbing. (Per City code 402.06) I also hoid the City of Fridiey and/its empioyees harmless for arty damages that ntay occur wfiile doing this
aperatian. This to include,but not limited to valves,piping,wails,floors or the curb stop box and service line. In unde�stand t am also required
io abtain a permit pcio�to any wark,if necessary.
FINAR METER READING(otd meter) O�O� ���
Name:�1�� f"V�VIt�� Address ��v ►^���t� ��
Phone 9Yum � �� ��Date �� ���Y 1
xSignature Witness Si�nature w
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OLD METER# ���—EJ ����
OLD READING ��� Z
NEW METER# 1 1����
NEW READtNG �
ERT# � ��`�"l Ly`
FRIDLEY CITY CODE
, CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,fi62,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or re�air of any water of sewer iine connecting the existing municipal system and any house or buitding for wfiich the
application is made,the owner or contractor shall6e required to obtain a permit for such connection,and shali pa+r a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the INater and Sewer Department shali be notif'�ed. it shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has I�en approved by the City as a
proper and suitabfe connection.
402.06 REPAIRS AND MAINTENAPICE 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 lead has
been extended to the property line for conaection,the applicant,owner,or occupant or user of such premises shati be liable for aif repairs
required to any water lioe and sewer lines necessary for con�ection of the premises from tt�e main to the premises. tF the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for tfie costs af the malntenance and/or
repairs,including necessary streeC repairs at a rate set annual(y by an administrative policy. It shall be the responsibility of the appiicarrt,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mairrtain the water senrice curb stop box for operability and at such height as wiii ensure that it remains aboae the finishec!
grade of the land or property. (Ref 638,1156,1191j
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Replacement No. �,Sz �G � ��
Replacement Reading !�
Replacement Make r. �
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Request for Service Report
City of Fridley
R eference N o: 601-11-2791 D ate: Ol 128111
Requesk Type: Turn waker afFlon Entered By: Jeannie Benson
Departmenk: Water Citizen Name:
Address: 190 IRONTON ST NE Callback Phone: 763-571-0454
Scheduled Date: Property Owner: Jill Kohler
Location Details: Shut water off at valve before meter and get Request Details= Water to be shut oFF and get meter
waker meter reading. Homeowner will meet reading_
you at site. Customer will be charged a
$25.00 Fee.�m's Quality Plumbing Placed
the call and has a permit with the City of
i r�diey Permit+�201 i-OG101
Action Taken:
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Responsible Person: , �,:"
�._.---..______._�y.��.7'ti"�— –,���%�
�Ko ymJ orgensen
Approver: �
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Completion Date: Ol l28l11-�df�f, ff'+fi � Citizen Notified
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