Meter Swap � Request Number: 15522
Public VVorks Division
Service Request
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Problem Address: 200 Liberty St Requested By: Mr.Hanson
Department: WATER Address: No address provided
ProblemlIssue: INSTALL AMR METER Phone Number: 612-327-2500
Scheduled Date: 2017-OS-25 Scheduled'ISme: 07:30:00
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ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-OS-23
ACTTON TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: �� '� Completed by: ���,�
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� �City of Fridley � �� �, ���j �/n �O�
,. Water Department ��D `TCJ
6431 llniversity Avenue NE � � ��,/�
Fridley, MN 55432 ��
?63-572-3566
�r'^�e hereby authorize the City of Fridley andJor its employees to do what is aecessary to
replace the water meter. 1 understand that the property owner is liable for the water line trom the anain to the premise and all irrterior
piumbing. (Per City code 402.O6j I also hoid the City of Fridley and/its employees harmless fo�any damages that may occur white doing this
aperation. This to incfude,but not limited to valves,piping,�ralls,ftoors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READItYG(old meter} L �`� �� ��
Name: _ ��^ Gh �'1�L��1 Address ���C G°(,� 1'..-.1 t'1 C�r'���I ���,
Phone lVumber � �� �u��"` ���� pate �" ��� ��
�5ignature Witness Signature "'—
OLD METER# ����� � �� �
OLD FtEADlNG � " ���� �
NfW MfTER# ���� � ���
NEW READING C�
E�T# ����,��c� � 3
FRIDLEY CITY CODE
�HAP'TER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATfON
(Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144, 1156,1141)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line conneding khe existing municipal system and any house ar bui(ding for which the
application is made,the owner or contractor shafl be required to obtain a permit for such connection,and shall pay a permit fee as p�ovided in
Chapter 11 of this Code. After such connection fias been made,the Water and Sewer Department shalt be noti�ed, it shall be unlaarFul to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been appraved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CO{UNELTION
After tfie initial connection has 6een 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 connection,the applicant,owner,or occupant or user of such premises shalt be liable for a{I repain
required to any water line and sewer lines necessary#or connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs af the maintenartce andJor
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shal!be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and�to maintain the r�vater service curb stop box for operability and at sucfi fieight as will ensure that it remains above the finished
grade vf the land or property. (Ref 638,1156,1191)
Request Number: 7625
Public Works Division
Service Request
Problem Address: 200 Liberiy St Requested By: Citizen
Department: WATER A�ddress: No address provided
Problemllssue: WATER MAIN BREAK Phone Number.
Scheduled Date: Scheduled Time: ,
ACTION NEEDED: Watermain break.
Created by: Wendy Hiatt Date Created: 2014-03-07
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Compieted: Completed by:
3-�- �
Request Number: 7864
Public Works Division
Service Request
Problem Address: 200 Liberiy St Requested By: Gordon Hanson
Department: WATER Address: IVo address provided
Problemllssue: OTHER Phone Number: 612-327-2500
Scheduled Date: Scheduled Time:
ACTION NEEDED: Clean up sand left on grass and blvd from water break repair.
Created by: Wendy Hiatt Date Created: 201405-07
ACTION TAKEN:
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Status: In Progress Residerrt Contacted ❑
Date Completed: Completed by:
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