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Meter Swap _ � ���� ; 1C����-y�9��� �� �' S=� INSTALLATION G7YOF AUTOMATIC METER REQDER FRIDLEY Address � � C�� � �`�L�,/ Name �a� �- �� J"�r c�z.e K Date � -� � — 1� _ _ _ _ Old Meter Number U �� �� Old Meter Reading �t� � Replacement Na O � / � a a / Replacement Reading � Replacement Make ��a-`�i '� ERT# � / 7 �� � �D `� Replacement ERT# Remarks: �a Signed: �� Request for Service Report ' City of Fridley Reference No: 601-11-3155 Dake: 06/27/11 Request Type: Turn water ofFlan Enkered By: Wendy Hiatk Department: Water Citizen Name: Cal-Cal's Plumbing Address: 21 65 112 WAY NE Callback Phone: 763-670-3842 Scheduled Date= 06128I71 8:U0 AM ���� Property Owner. Kathy Mrozek Location Details: Permit#2011-00988 � Requexk Details= Shut water oFfllea+re key """B I LL""'" Action Taken: � � .—�,.._ _ _._.__--- ----- �► -- �-----��— — , rv/'✓t�� p,��' (,c�ci '�F'� �;�.��/ �.p F { l/ �'y �,�" �lv��n�P�,� I Responsible Person: ; �/�^ , � Approver: i L_ Completion Date: � ❑ Citizen Notified � � �� �� Request for Service Report , � City of Fridley R eference N o: 601-11-3140 D ate: 06IZ1!11 Requesk Type= Turn water ofF�on Entered By: Wendy Hiatt Department: Water Citizen Name: Cal-Cal's Plumbing Addrexs= 21 65 1I2 WAY NE Callback Phane: 763-670-3842 Scheduled Date_ 06l22J71 8=30 AM � Property Owner: , Location Details: Permit 2011•00988 Request Details: Shut water oFFfleave key '""`BILLx""' Bring meter with. Meker is leaking Action T aken: �_�_�.. ��cJl� /i C�� J�U� ��F L�C/Cc%r� �c7!'✓1�'�O C�I'�.� 1 � �av��� � Nf�c//��'��� �� 1'P� Responsible Person: � (/C����� � � Approver: � i � Completion Date: � Citizen Notified � � �� -�� � . Request for Service Report City of Fridley Reference No: 601-11-3163 Date: 06I29111 Requesk Type: Leaking meker Entered By: Wendy Hiatk Department: Water Citizen Name: Cal-Cal's Plumbing Addrexs: 21 65 1I2 WAY NE Callback Phone: 763-670-3842 Scheduled Date: 07JU7111 $=00 AM �Yl� Property Owner: Kathy Mrozek Location Details: Request Dekails: Change leaky meter Action T aken: �_____� __ — ---� _____ _ �._ _�._---- -- --, � C� ��,K '% ,� � � '�C�► � )""e��-.e �'- � � � I � � � � � � � � � � 6 � � �- � ��� ,�+� # �`� � .� �o � �, � ���f� � � � � � �e t� ��.tr �# �"( � � � , a a 7 � rie-�. ,�►,d.r� � � � �"T -� �-� 7 �b I�a � � € �� �__ _____ ;_ � � Responsible Person: j ��`-� E .. �..__ � Approver: � — Completion Date: �— �Citizen Notiiied � ��� - i 1 City of�ridley �'at�3 De�art�ent 5�31 t?�.versity_�venue 1��L. Fridley�i�l 5���2 �ib�� �7�-�J��. � i/we�IC�(.�C=R(�l.'� I'1�'Iltt�7�.-(G �E{ebti auti�o���, ihe �it�v o�r�.ciley a��'1or iis - employetis �fl do �r�a�y�e��ssary t�_L-�la�e�.he wate�me��r_ i_unde�stand that;.�e properiy owner i� 1_ia�le iox the�-aafer line�o�i.�e m�to t�e p�e�isv an�.' all ini�ror �lunbi�g- (�er�i� c�de 4Q2.0� I a?so �old�.e C�t;oi Frid�ey andfor its e�lo�Te�,S �ar�less ior any damaQes t�0.i ma;r o��u�w.l�ile �o�n�t.�is ope�aiion_ T}iis ��in�la�i�.but �oi li?nite�.to; valves, pipin� wa11s, foors or t�e ��� sto�box an� sti�rice liae_ 1 �.dersrand I am �.ls� requir�d�o obt� a;�-�ii��_o��� �.��io-� s�neti�ssarV. �`Iame_ _4��.ess: t hone i��o.ber: �Qt�: ��: / — l/ . t Si_ffnat�u'e' �'L' �, ; h.t-�L �l` � �, .�- �nTitness Si�ature: ����-� �7� � Ty-� ii :• � .�iTLi1� `lJi7�L' .- - L391.�a.�31'�,1�1 �j�bo���.����J3'1,i9.R1'3'� :"Y!�g`y�i.�.t31�Jt3193S�1 ��YV.L'�.i� � �1'Y'�3a7 3.1'a_��1��� (kei Ord i�*i-0 11;,1b�,5b�, �ob, 02�, o�o°, o'o?,92^,9�a, 114�, ll�o, I191) =ia2.�5. 3'�'�I��'�'�; , �ror to cansuuc�n�or rep2ir oi any�,vaie:or sewer liue cor�aeciing t]se e;�istiab municipal system and any house or buiIdia�=or���iicn t�e ar,pl�cation is made,the o�er�r cantractor a33a1�be re:�uire�.to oorain a peu�it for such conne��ion, azd sha17 nay a per.nit fee as provideri in Cna�ier 11 oi-i�is Code_ _Sfter�such cann�ctian has buen�acie,;he St7�zr��gewe<�epas-tmeni�all be no�e� i#shall�e urlawnii tL co��er any ccnne��n�iine uzitil azi inspection has been�ade and such c�nne��on and the wor3�i�cid�ni ti�ereto has been a�pre4ed�y�e Ci�T as a prooer�c�saitable canne�tion. �02.fl�. �.���<��1��1�T'�'��Ta�''T�.� '�'� �.�i������1T Afte�+:he initial.conaection has be�n�ade tt�i�ti�.�rater se�!ic� c�.�b siop bo�or��e szwer lezd�i.tie proper�j line o�a wate:servi��3r seurer�eaci�as b�Un z�yndea�o the pra��-ty line fcr canuec+�on;i�.e applicani, o�ner, or�e�c�upani or�iser 3r suc��rzmises s�all be liable tar aii i e�a;rs req�d�o an3� �vaier line �d any seurer lines netiessa.�,�f�r connecrion os;3,e.Dremises�flm�e main ta �.he�zem�ses. Lf - t�e praperi.y o•�r�er reauesis�uinizrance se;y;c�s or re�,au�de periormed�y the �iiy,�e proper=y ou�ner shall be c�ar�ed ior�e costs oz ihe mai�teLancti a�d/o�:�pa�s, �nc3�;dinQ HIlV ne�essai�szre�t repairs, dI 3 rate set�ualiy oy an aamir�i�-aiiJ�policy. ?r_s�a31�e the res�ansibi?it�r ofthe a�plic�z, ��vuez, oc��s�anl oz us�r to peri�riL sta�darc�mainzeuauc�o'r'ihe sewer servic�'�e aom tha arenises io the�ain inc�u�g de'�i-is clea.�-ing OF T�Ot C�11�'L�'3TiEl i4 II131i1T3�Il`L�'i�wai�r s�r�rie� curb s��p b�ti i�r o�erabilitv and at su�� hz;�t as�i]I�5nre��at;t re�u�s aba�r�`ue fiazs�L��a�e o�u�e l�d or�roperiv. �ei 6��, 1��o, 11�?)