Meter Swap . ,
Request Number: 12924
Pablic works Division
Service Request
Problem Addreas: 1377 Meadowmoor Dr NE Requested By: Kenneth Novak
Department: WATER �4ddress: 1377 Meadawmoor Dr
Fridley,MN 55432
Problem/Issue: INSTALL AMR METER P6one Number: 763-'744-7248
Schedule e: 2017-01-2S Sc6ednledllme: 01:0(l:�
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ACITON NEEDED:Install AMR
Crexted by: Beth Kondrick D�te Created: 2017-01-17
ACTION TAI�N•
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Status: In Progress ��tter H�u Beee �..,
Cont�ted
Date Comp[eted: ����_�� Completed by:
-�7 ��
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�i�/or rriaoey
Water Department � �j � L � �
6431 Universit'/Aven�ae NE
Fridley, MN 55432 �� �,._� �S�yl� —�
763-572-3566
� �/+Ne hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. 1 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 C'�ty of Fridley and/its employees harmless#or eny damages that may occur while doing this
operation. This to include,but nat limited to valves,piping,walls,floors or xhe curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meterj V 1 v� ! ���
Name: I�L'V1,��� �G'i/7,.�--- Address 1���� �°�o W t�/LO OP�' �r� N'�
Phone Number `��3��L`�� �7�V p�e � 1�� r ��
Signature YVitness Signature '�
OLD METER# �" 1�� p��..�
OLD READtNG � I � J ���
NEW METER# U i �, I �� � �
NEW READING �
ERT# � ��� � � v�7`
FRIDLEY CITY CODE .
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Plo 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipai system and arry house or buiiding for wh�ch the
application is made,the owner or contractor shall be required to abtai�a permit for such wnnection,and shafi pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shall be notified. tt shali be unlawful to cover
any conneding line untii an inspection has been made and such connection and the work inciderrt 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 senrice curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connedion,the appiicarrt,owner,or accupant or user of wch premises shaii be liable for all repairs
required to any water line and sewer li�es necessary for connection of the premises from the main to the premises. ff the property owner
requests mairrtenance service or repairs be perFormed by the Cityr,the property owner shaii be charged for the cosCs of the maiMenarxe and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative policy. It shall be the responsibility of the applicartt,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to mai�rtain the water service curb stop box for operabil'rty and at such height as wiil ensure that it remains above the finished
grade af the land or property. (Re�F 638,1156,1191j
Request Number: 6184
Public Works Division
Service Request
Problem Address: 1377 Meadowmoor Dr Requested By: Kenneth Novak
Department: WAIER Address: No address provided
Problem/lssue: TURN WATER OWOFF(WATER) Phane Number: 612-913-2882
Scheduled Date: 2013-05-22 Schedufed Time: 01:00:00
ACTION NEEDED: Turn off water for repair. Permit#2013-00901 """"'BILL'""'"`
Created by: Wendy Hiatt Date Created: 2013-05-22
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by: ��
.S " ?� � � 3