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Meter Swap , Request Number: 15441 Public works Division Service Request Problem Address: ll 6 Logan Pkwy Requested By: Julie Xiong Department: WATER Address: No address provided Problem/Issue: INSTALL AMR METER Phone Number: 763-898-0909 Scheduled Date: �2017-OS-23 Scheduled'lime: 10:00:00 I ��S !�r..�.�.r �3`'� jC�c�►^'1 ACTION NEEDED: Created by: Beth Kondrick Date Created: 2017-OS-18 ACT[ON T N: �� .........._V_V�.�....................._�.�.................'T'"'.................................._......___............................................................................................................................................................................................................._..................................... ................................................................................................................................................................__.........................................................................................................................................................................................................._............_.,................. ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,_...................._........................................................................................................................ ........................................................................................................................................................................................................................................................................................................................................................�...�.._.__.m..........._...................... ................................................................................................................................................................................................................................................................................................................................................................................................................... ................................_...._............................................................................................................................................................................................................................................................................................................................................,............................. Status: In Progress Submitter Has Been r Contacted Date Completed: Completed by: �= Z- 3� l `1 `� �8 r � . 3�� -- �� D -�3 . City of Fridley Water Departrnent c�� , l�� 6431 University Avenue NE V �� Fridley, MN 55432 763-572-3566 �lwe hereby authorize the City of Fridley and/or its employees to do what is�ecessary 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 piumbing. (Per City code 402.06) 1 aiso hofd 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 wark,if necessary. PINAL METER READING(old meter� �� G � Name:�U �� Address 1� ' r IL� � '- _-i��/' �� Phone Number �� l.�pate � �� Signature �_ � Witness Signature OLD METER# lJ l � � ��--v —1 OLD READING � �� — ` {Q NEW METER# �f�1,��v� NEW READfNG � ERT# I � �� I �� FRIDLEY C{TY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMtNISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156,1141) 402.5 PERMfT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the application is made,the owner ar contractor shaN be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connedion 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 connection. 402.06 REPAIRS 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 lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liabfe for all repairs required to any water fine and sewer lines necessary for 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 of the maintenance 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 user to perform standard maintenance of tfie sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service curb stop box for operabi{ity and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) F�€�q� f+ar�r� F��r# ��c�f Fr�d� � � �; �1-�2-5�01 . 11,J�l�12 Tjt�e: Tu��ateF a�d�nn �: e�: Mlfater fi�tizen t+�e: ,�{�rg = 11�L�GII�#P�04�1i''1� . �-9�Ri Se3re�d[]�e= 71/'�''�1211�l1i1 Pl�ap�jrt)+�r�a_ �: �63-30i1-i� ��: �#t 20�2-0�i79� �re�Uir�tais: �ut aB�erfior�ar_ Lea�iae�_ � _ �� rr-- � ��`� �-� t-�=� l� � ��c� �� t�'�' ��-e L�--�`� � . � _. �. _s�.n._ _ _ . � ;�� j� � � �� ____ .._....�_._ �.�_�.._.� � _ - j . _ �.. _______�_ ____ _ _ �� _ l� � . _��.__�___ _.__ . _ . �� o _ . _ . � , City of Fridley . � ' Water 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 understand that the praperiy owner is liable for the water line from the main to the premise. (Per City code 402.06) I also hold the City of Fridley andlor its employees harmless for any damages that may occur while doing this operation. This to i.n.clude,but not limited to, sod,yard,landscaping,trees, shrubs, driveways, sidewalks or the curb stop box and service li.ne. I understand I am also required to obtain a permit prior to any work. � Name: Address: �� CtiA�i�) ��:�� Phone Number: Date: r� —�I�� Signature: � Witness Signature: �� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADNIINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156,1191) 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the e�sting municipal system and any house or building for which the application is made,the owner or contractor shall be required to obtain a permit for such connectian,and shatt 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 unlawfiil to cover any connecting li.ne until an inspection has been made and such connection and the work incident thereto has been agproved by the City as a proper and scritable connection. 402.06. REPAIR3 AND MAINTENANCE TO CONNECTIUN Aftar the initial connection has been made to the water service curb stop box or the sewer lead at the properiy line or a water service or sewer lead.has been extended to the property line for conneckion,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 necessazy for conneciaon of the premises from the main to the pzemises. If the properiy owner requests maintenance services or repairs be performed 6y the Ciry,the properiy 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 adminittrative policy. It shall be the responsbility of t}ie 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 water service curb stop box for aperability and at such height as will ensure that it*��inc above the fnished grade of the land or properiq: (Ref 638,1156, 1191j Req�est fc�r Seraic� Rep�rt �ity of Fndley Reference No: �-12-5175 �a�e: S�'�J2'01z Fi�que� T�tpwe� Se�e back�ap ct�edc C�►�ain ��d f�y: W��t C�parkme�#: S� Gtii�Name: �e 7Gflng Addr�ss� 11fr�.CK'�AM PKWY NE �e�c Phcan+�: 763-�s�1'-93� Sd�hiled I�e: Prope�ty Ch�r: E.aca�ion T7eta�s: � Detaila: Bac�a4_ Che�lc Cit�►Main ;4ction T�c�en: _- _____-___ - i , � � � � , ��- � C�- � ; • (�� - � � �� p(� ; � ' � '� � ; � � � � � 1 . �- � 1 � 1 ; ; � ; � ; ; _ ._____ _ _ _ ______ __._____� ��P�_ �-� ,�ve�: �.,,, Crsrr�e#icm Da�+e: ^ � � �z+en N+��exi , v V! .rr �� .. n .. . ��s� f+�f '�r�a� � Ci�yy af Fndl�y �: �-�2-5t7� ��: 12 T�e� Se�t�ack�p�eck t��r� �rat,�#�j+� �: Se� �z�re�: J�ie Xrarg 1W�+ess� 1iS LfJGAt�1�"K1l�Y 1� . 76�i71-9�#70 [l�e= _ �t L1e#ai�: 6��eia'�s: Bad�_ f�rec�Q�►ilan Tat�� a pi�ir� . �aacy �cat . � � � I � � , . 9 � � � �.___� ___ _� ...�e_. ___ �.._.. __.______ __� _._ �__.__ _ ___ � f�e�ans�te P�� ..�_..�_._��......__.�.__�_...._..__.........____.� __. _....�_.�_ __--__ � '�� _._..._..�._...............� _.__, ___............._�......._____________ ...__ _.�__.�._______ � � �� C�S�e: 8��2�4�� i�ed