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Meter Swap . � Request Number: 12472 . Public Works Division ' � Service Req�st ' � � Problem Address: 7421 Jackson St itequested Byc Ray Dietrich � Depirtme�: WA'IER Addreaa: No address provided ' � Pro�em/Iaaue: 1URN WATER ON/OFF Phone Number: 651-428-7987 . �' ` Schednled Date: 2016-12-]9 ScLednled'ilme: 10:00:00 ' � � ACIiON NEEDED:Shtrt offvuater ao he can replace val�e before meter. • . � Created iry: Wendy Hiatt Uate GYested: 2016-12-15 � ACIION TAI�N: � • ��(�-�t"�'C'� �OU �.� _,l�C�Z" v 2�1 4 Yj-- . . - ,�-� ��-�� , ��,c�� —1��7E�:� . ��,�c.t N� �UvT —t'� C��-�t-,2 , �� ./Uv`T t2.�—r�c.� ' ��.�� `�J��.�C��J I��iZ, " Statns: Tn Progress Snbmitter Has Been �, Co�acted Dite Completed: Completed by: I � - ��- � , � � � . City of Fridley �Vater Department , ' 6431 University Avenue NE Fridley MN 55432 • (763) 572-3561 Uwe 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 un.derstar�d that the progerly owner is liable for the water line from the main.to the premise. (Per City code 402.0� I also hold the City of Fridley and/or its employees barmless for any damages that may occur while doing this opera.tion. This to include,but not limited ta, sod,yazd,landscaping,trees, shrubs,driveways,sidewalks ar the curb stop box and service line. i understand I am also r�quired ta obtain a pennit prior to any work. 1rTam.e: Address: � Phane hium.ber: Date: Signature: Wi�aess Signalure: TRII?LLY CITY CODE C`AAPT'F'.R 402.wA��,sToxm�wA�x Arm s.�rrrr.�xY s�w� ADNIINISTRATION (Ref OrdNo 113,464,565,566,629,638,fi62,922,988, 1144,1156,1191) 402.05. PERM[T FTE Prior to constractin�or repair of any water oz sewez line conneciing the existing municipal system and say house or building for which th.e application is made,the owner ar contractor shall be required to obtaiu a pem�it for such connection,and shalt pay a.permit f�e as provided in Chapter 11 of this Code. A,fter such coffiection has been made,the Water an.d S�wer Depaztment sl�all be notified. It shali be imlawfiit to cover any connectmg line until an.inspection has been made and such cannection a�id the worl€incident thereto has been aggmved by the City as a proper au�saitable counection 402.06. REPAIRS AND NiAINTENANCE TO CONNEGTION Ai�ar the initial connection has been made to the water service cvrb stop bnx or the sewer lead at the pmperiy line or a water service or sewer lead has been exkended to the PmpertY lme for co�e�t►°n,1i�e applicant,owner,or ttxa occupant or user of such premises shall be liable for all repairs required to mry water lin:e and aap sewer lines necessary for cannection of the premises from the m�tn the premises. If the property owner requests maintenance services or repairs be perfonned by the City,the property owner shall,be charged for the costs af the maintenance�nd/or repairs,ineluding any necessary s�et repairs,at a rate set an�.ually by an admmistra#ive golicy. It shall be the responsibility of tt�e spplic�t,owner,occupant or user ta`perform staudard maintenauce of the sewer service liwe fram i�e Pr�ises to the main includ'nng debris clearing or roat culting and ta maintain the water service c�b stop box for operab�ity and ai sach hei.ght as will ensure t�hat it*�ains above the finished grade of the land or property: (Ref 638,1156,1191j • City of Fridley < �j I� ( � Water Department -� 6431 University Avenue NE Fridley, MN 55432 �jL�j��(a-I �� 763-572-3566 I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06� I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required to obtain a permit prio�to any work,if necessary. FINAL METER READING(old meter) '��`� �� I� 1 �1��..� Name: ��`�`��C �� 7 Address Phone Number Date a �� Signature 1� Witness Signature � S6� � � OLD METER#_ � � �� OLD READING i � �15 W�� ''�''� NEW METER# �� ' � V�v � NEW READING � ERT# ��0� r � V�p FRIDLEY CITY CODE � CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or building for whid�the � application is made,the owner or contractor shall be required to obtain a permit for such connection,and shalt pay a permit fee as provlded in �n Chapter ii 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 suitable wnnection. �� 402.06 REPAIRS AND MAINTENANCE TO CONNECTION � `.'� After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water servi�tead has '� been extended to the property line for connection,the applicant,owner,or occupant or user of wch 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 maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant, �* owner,occupant or useK td''perform standard maintenance of the sewer service line from the premises to the main inc{uding debris ciearing or �i root cutting and to main�iin the water service curb stop box for operabiiity and at such height as will ensure that it remains above the finishgd � grade of the land or pr�rty. (Ref 638,1156,1191) ��n;��; i �