Meter Swap Request Number: 15404
� Public works Division
Service Request
Problem Address: 7127 Riverwood Dr Requested By: Joanne Korluka
Department: WA'IER Address: No address provided
Problem/Issne: INSTALL AMR ME'IER Phone Number: 571-9750
Schedul�d Date: 2017-OS-18 Schednled'Rme: 02:00:00
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ACIION NEEDED:
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Created by: Wendy Hiatt Date Created: 2017-OS-U
ACTION TAI�N:
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Status: In Pro s Submitter Has Been r
��; Contacted
Date Completed: �,� �((�"�� Compteted by: ����
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��1� - 5���� � " Or
City of Fridley
` Water Department
; 6431 University Avenue NE
Fridley,MN 55432
763-572-3566
��VNe hereby authorize the�ty of Fridley and/or its emptoyees to do what is necessary to
repiace the water meter. I understa�d that the property owner is liable for the water line from the main to the premise and all iMerior
plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmtess for any damages that may oaa►r whife doing this
operation. This to inciude,but not limited to valves,piping,walls,floors or the curb stop bax and service Itne. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter) � ✓ � ! �
Name: �J C� Gll,�� ���,•"r"7lddress V�� I U'��7��r w� � l �.
Phone Number �� �� �� ��/ p� 5 v L� `-'�,�
�--►
Signature Witness Signature
OLD METER# _ �CJ C �CJ
OLD READING_ ������(J�D
NEW METER# � l. �� �" ! 1 �
NEW READING �
ERT# � 1 � 1 1 '`��
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FRIOLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITA►RY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constn.uting or repair of any water of sewer line connecting the existing municipal system and any house o�Iwilding fo�wh+ch the
application is made,the owner or contractor shall be required to obtain a permit for such wnnection,and shali 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 he u�lawfut to cover
any cannecting fine 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.
4Q2.�6 REPAIRS APtD MAINTENANCE TO CONWECTIOPI
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
6een extended to the property line for connection,Che applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water lioe and sewer{ines necessary for connection ot the premises from the main to the premises. ff the property owner
requests mainte�ance senrice or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs.inciuding necessary street repairs at a�ate 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 inciuding debris clea�ing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the�nished
grade of the(and or property. (Ref 638,1156,1191)
Request Number: 7'l51
Public Works Division
� Service Request
Problem A�ddress: 7127 Riverwiood Dr Requested By: Mike Korkula
Department: WATER Address: No address provided
Problem/Issue: TURN WATER OWOFF(WATER) Phone Number: 571-9750
Scheduled Date: 2013-10-24 Scheduled Time: 08:00:00
�` � `�
ACT10N NEEDED: Turn off water. Leave Key. Plumber has permit. """`"'BILL"""'"`
Created by: Wendy Hiatt Date Created: 2013-10-18
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
I ��a�1- ��
,. ' City of Fridley _
Water Depart�tnent
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 praperty owner is liable for the water li.n.e from the mai.n.to the premise. (Per
City code 402.06) I also hold the City of Fridley and/or its employees harmless for any
c�amages that may occur while doing this operation. Tlv.s to i.n.clude,but not limited to,
sod, yard,landscaping,trees, shrubs,driveways, sidewalks or the curb stop box and
service line. i understand I am also required to obtain a permit prior to any work.
Nam.e: � � 1�� ��o'�t V�-g Address: � I�'-7 �� v�.C"wa�C ��
Phone Number:�b� � 7I-�7 5 ' � Date: � � �"
Signature:
Witness Signature:
FRIQLEY CITY CODE
CHAPTER 402.WATElt,STORM WATER AND SANiTARY SEWER
ADMINIISTRA.TION
(Ref Ord No 113,464,565,566,629,638,662,422,988, 1144, 1156,1191)
402.05. PERM['i'I+TE
Prior to constructing or repair of any water or sewer line conneeting the existing municipal system and any
house or building for which the application is made,the owner or contra.ctor shall be required to obtam a
permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such
conneetion has been made,the Water and Sewer Deparlment shall be notified. It shall be wilawful to cover
any cannecting 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 sQitable connection.
402.06. REPAIRS AND MAINTEN.ANCE TU CONNECTION
Aftar the initial connection has been made to the water service curb stop box or the sewer lead at the
properly line or a water service or sewer lead has been extended to the property line for conn�tion,the
applicaat,owner,or the occupant or user af such premises shall be liable for all repairs required to any
water line and any sewer lines necessary for connection of the premises from the main to the premises. If
the property owner requests maintenance serrvices or repairs be performed by the City,the properiy owner
shall be charged for the costs of the maintenance and/or repairs,including an.y necessary street repairs,at a
rate set annually by an a mini�trative policy. It shall be the responsibility of the applicant,owner,occnpant
or user to'perform standard maintenauce of the sewer service line fram the premises to�e main including
debris cleating ar roat cutting and to maintain the water service curb stop box for operability and at such
height as will ensure t�iat it r�ains�above the finished grade of t�e land or property. (R.ef 638,1156,1191j