Meter Swap Request Number: 17164
. r��wo�n;��on
• Service Request
Problem Address: 7600 Lakeside I�d Requested By: Lyiu�Grigor
Department: WATER A�ddres:: No address pro�ded
Problem/Iss�: 1NS?ALL AMI�ME1�R Pl�oae Namber: 763-78U-4567
Sckeduisd 2U17-11-03 Sc�duledllme: 09:00:00
r� .
AC�ION 1�ED��a�t�se�pY�ber c�ct�e v�lwe.�ror�ha�'i�MIE.
Creatad by: V�leedy Hi�EE Da�e Cre�tei: 2�1 T-10-30
ACiION�'.4�El�i:
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Grli� JnS���u1 Ct•• /qy17/�
St�ua: In Progees� Snbmittar�Been r,
Ca�tacted
Date Cee��t�: Campleted by:
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City of Fridley
Water DeparLm.ent
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 c�b stop box. I understa�.d
that the progezty owner is liable for the water lin.e from the main to the premise. (Per
City code 402.0� I al.so hold the City of Fridley and/or its employees harniless for any
damages that may occur while doing this operation. Thi.s to include,but nat limited to,
sod,yard,landscaping,trees, shna.bs,driveways,sidewalks or the curb stap box and
service line. �undersfan.d I am also required to obtain a pemsit prior to any wark.
Name: Address:
Phone Num.ber: Date:
Signa.ture:
Witness Signa�ure:
FR]:D�L�Y CITY CODE
��APTER.402.'WATER,STORM WATER AND 5ANTTARY SEWIIt
AUIVIINISTRATION
(Ref OrdNo 123,464,565,566,629,63$,662,922,9&8,1144,1156,1191}
4U2.05. PERMTT FTE
Prior 1�constructmg or repai�of any water o�sewer iine conneccling the existmg municipat system and any
house or building for which the applicaii.on is made,the owner or com.tractar shall be reqaired to obtam a
peamit for such connactian,and shaIl.pay a.permit fee as provided in Chapter 11 of this Code. Af�et snch
connecti.on has been made,the Water an.d S�wer Departm.ent shatl be notified. It shall be nnla�aeful to cover
any cannectmg line until an inspection has been ma.de and such conueclion and the worl€incide�t there#o
has been approved by the City as a pmper�.�smta�ble cozmection.
402.06. REPATRS AND MAINTEI+TANCE Tt7 CONNECT'I�N
Af�ar the initial connection has been made to the water service curb stap b�x or the sewcr lead at the
properly]ine or a water service or sewer lead has been extended.to the FioP�Y line fnr camnectirnu,the
applicant,owner,or the occupant or user of such pre�mises sha)1 be liable for ail repans requaed to may
rvater lin:e and any sewer lines necessary for connectian of the premises from the main to#1�e�emises. If
the property owner requests maintenan.ce services or repairs T�e per.foamed by the City,the pr�periy owner
sha.11 be charged for the costs of the main.tenance an.d/or repairs,inclnd'mg any necessary sti�eet repairs,at a
rate set ann.ually by an admmistrative policy. It shall be the responsiblity of the applic��wner,occupant
or user to`perform standazd maintenance of the sewer service lin.e fram i�e premises to t�e mana in,rluding
debxis clearing ar roat cud�ing and to ma.intam the water service c�b stop b�g for operab�.1'tty go.d.at such
height as w71 ensute that it reanai��abave the finished grac�e of the land or property: (Ref 538,1156,I191j
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