Untitled Request Number: 12371
� Public works Division
Service Request
Problem Address: 7374 Memory Ln Requested By: Orville Nergard
Department: WATER Addr�ss: No a�ress ptovided
Problem/Iseue: INSTALL AMR ME1ER Phone Number: 763-?84-7857
Schedul � e: -12-14 c ,,. Scheduledl'lme: 11:30:00
�`r`\ � � C�
AC1iON NEEDED:AMR
Cres�ted by: Wendy Hiatt Date G'�e�ed: 2016-12-06
ACIION TAI�N:
�n,s�,l l�d �tM�.
Statvs: In Pro ss Sabmitter H�Been r,
� Goetacted
Date Completed: �2—' �� -� I� Completed by:
� ..,.. ..._..
City of Fridfey � r�. � /_,`� �
Water Department ��' �t �
6431 University.Avenue NE
Fridley, MN 55432 �� yS�S—P,C�u.�`
, 763-572-3566
I/we ���ti l'`E.- ���'�C�^�c�� hereby authorize the C'rty of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand t t the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley artd/its employees harmless for any damages that may oaur 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 prior to any work,if necessary.
FINAL METER READING(old meter) /�� � l � �v
Name: Q r1����� 1Ve�rc a � _ Address �"7�� �'Q�� `��%�1!1`t
Phone Number � " / '� / J Date ��� � "1 � � �
� ;= ,�..._ , X
�. Signature � Witness Signature I� �D✓
OLD METER# I �� V �C9 i �'�
OLD READING � I � I ���
NEW METER# �� � I �� � �
NEW READING �
ERT# �g�7r� a-� �
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 constructing or repair of any water of sewer line wnnecting the existing municipal system and am/house or bullding for which the
application is made,the owner or contractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shall be unlawful to c.over
any connecting line until 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 CONNEC7'ION
After the initial connection has been made to the wate�service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the applicaM,owner,or occupant or user of such premises shall be liabk for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance senrice or repairs be performed by the City,the property owner shall be charged for the cosrts of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the ftoished
grade of the land or property. (Ref 638,1156,1191)