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' Request Number: 16510
Public Works Division
Service Request
Problem Address: 7573 University A�ne Requested By: Ron
Department: WA1ER Address: No a�ress provided
Problem/Issue: INSTAL,L AMR METER Phone Number: 763-792-9731
Scheduled Date: 2Q17-0?-31 Schednied 1ime: 10:00:00
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ACITON NEEDED:Install ANIlt.ANIlt is behind water heater.
Created by: Wendy Hiatt Dnte Created: 2017-07-31
ACTTON TAI�N:
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Date Completed: Completed by:
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REQUEST FOR SERVECE REPORT
�ITY OF FRIDLEY
Reference No. Date•
Request Type: Entered By:
Department: Citizen Name:
Address: Phone Number:
Scheduled Date: Property�wner.
Location Details: Request Details:
Action Taken:
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APprover:
Completion Date: Citizen Notified:
� � � �i���Se%c��ey ��(p -" ������`�V�
Water�eparte�eret ;��
5437.l7�iversity Avenue NE
Fra�lt�y,MtV 55432 � � �� /
763-5�2-3566
a/we hereby authorize the Cty af Fridley and/or its em�loyees to do what is necessary to
reglaca the water�net�r. {understand that the property owner is�iable fos the water{ine from the main to the�remise and all�nterior
plumbing. (Per�L'tty sode 402.a6) 1 atsv hold the C'rty of Fridley and/ets employees harrnless#ar any damages thafi rnay occur while doing this
operatian. 7'his to inctude,but not limified to valves,piping,watis,#loors or the turb stop box and senrice iine. !n understand i am afso require
to obtain a perrnit preor to any work,if necessary.
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Signature .'��� � Witness Signature � ~
Ol.D METER# / IU�� ���5�
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FRIDLEY CITY CODE
CFBAPTER 402.WA�'ER,STORM WATER AMD SANITARY SEWER
ADMlNlSTRATlON
(�tef Ord No 113,4G4,565,566,629,638,662,922,988, 11�4.,1156,1191) „
402.5 PERMIT FEE "
� Prior to constructing ar repair of any water cf sewer line connecting Che eidsting rr�unicipa4 system and arry house.,gr'�dkiing for�rhich the
applicafiion is made,the owner or contractor shalf be required to obtain a perrttit for suc6 connection,and shatl pa�'�permit fee as provided in
Chapter 11 of this Code. After such connection has 6een made,the Water and Sewer Department shali be notified. It shail be uolavvfu(to cover
any connecting li�e unti!an inspection has been made and such connection and tt�e work inciderrt�Ehereto has been approved by#he City as a
proper and suitabie connectioR.
40ZA6 REPAIRS AND MAIAI'iENANCE TO COIYNECTION
After the initiat connection has been made to the water service curb stop 6ox or fihe sewer tead at the property line or a avater service iead has
been extended to the property line for cannection,the appficarrt,owner,or occupant or user of such premises shal{be iiab{e for aii repairs
requised to any wafier line and sewer tines necessary�o�connection af the premises from the main to the premises, tf the property owner
requests mairrtenance service or repairs be perFormed by the�ty,the property owner shall be charged for fihe costs af the mai�tenance andJo�
repairs,including necessary street repairs at a rate set annuaity by an admirtistrative policy. 1t shal!be tf�e responsibility of the applicarit,
owner,occupant or user to perForm standard maintenance af tf�e sewer service line from the premises to the main including debris dearirtg or
root cuttirtg and to mair�tain the water service ceirb stop 6ox foc operabifity and at such height as will ensure that it remains above the finished
grade af the land or property. (Ref 638,115b,119T)
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