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Meter Swap '� �l �(n�35'—�� / � INSTALLATION c�nroF AUTOMATIC METER READER Fr�n�.�r � �-S7 Address � la`( Name �� Date � �`- �` Old Meter Number �� Old Meter Reading �.� Replacement Na �rJ�oZn�,�J� Replacement Reading � Replacement Make�_� ERT#___c��b v Replacement ERT# Remarks: ` �3� $igned: Req�st for �� Repc�r# . �G�ty of Fndley R��c��ica: �1-11-3�71 Date: 10t27f2'U11 Request Type� �estail AMR n�etef Errt+�d By: Wersdy F�G�t [�partm�n#: Vaf�er Gtizen �lame: Fr�rk�arpe Addr�ss� 5�24 5TH ST NE C�adE Phvn+e: 7fi3-571-6981 Sc:heduled Date: t�/3111[!11 11_�AM (�� mperty Owner. Locatic�n CJeta�i�: � f�equest details: instalt ANR Adion 7aken: l ��s�. ��ti'� E � � 0 u� ��—re2 �# —3D�l�S(� o�'��c�._ g77o3� U�� M�r�� t —y354�.55 �,�k'-�o �r.� .— � � � �- �J�(�� E ' .. ... . ...... ..._ ... __� ��SF3a�13��EfSQti: �YGY: G�r�lUtl��e: __._ �� - ------- [�C�l�+e(1 NOt#lec! � � __ _ _ __ � . . City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe �f"�i/j�' � S��}�� hereby authorize the City of Fridley a.nd/or its employees to do what is necessary to replace the water meter. I 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 City of Fridley and/or its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to; valves, piping, walls, floors or the curb stop box and service line. I understand I am also required to obtain a permit prior to any work, if necessary. Name: Address: Phone Number: Date: Signature: Witness Signature: FRIDLEY CITY CODE CHAPTER 402.R'ATER,STORM WATER AND SANITARY SEWER ADMINI�TRATION (Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144, 1156, 1191) 402.05. PERM[T F'EE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall 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 be unlawful to cover any connecting 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 suitable connection. 402.06. REPAIItS AND MAINTENANCE TO CONNECTION • After the initial connecrion has been made to the water service curb stop box or the sewer lead at the property line or a water service or sewer lead has been eactended to the properly line for connection,the applicant,owner,or the occupant or user of 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 services or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or r�pairs,including any necessary street repairs,at a rate set annually by an adminis�arive policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensvre that it remains above the finished grade ofthe land or property. (Ref 63&, 1156, 1191) � � Request Number: 11056 Public Works Division Service Request Problem Address: 5924 Sth St Requested By: Department: WATER Address: No address provided Problem/Issue: WATER MAIN BREAK Phone Number: Scheduled Date: 2015-12-26 Scheduled Time: ACTION NEEDED:Water main break. Created by: Wendy Hiatt Date Created: 2015-12-28 ACITON TAI�N: : , � � J D � -��-�`- ............................................_��c t.,v/�'..............�r..��..'.�........................�..L..r�i' .............................._�9_1�...............:........�.................._............._......._J....... ............_.._....�_.............................. ......................................................................................................................................................._.........._.............................._.._..._._..................................................................._......._...........w..........................__............_.......................___...__........_..... ..............................................................._................................................................................................................................................_......................._........................................_......................................._._....................................__._._____............__....... ............................................................................................................................................................................................................................................._...__..._..___..........___..._.........._..._......_._.._............._...._...._._..__._........................___........_. .............................................................................................................................................................................................................................................................................................._..........._.............._......_........._.........._.....................�.__._._....._.... Status: InProgress ResidentContacted C Date Completed: Completed by: � ? Z G l S" -_�� r � Hiatt, Wendy From: � do not_reply_mn@korweb.com Sent: Saturday, December 26, 2015 8:11 AM To: gsrequest Subject: Ticket 153600007 Sent by GSOC One Call KORTERRA JOB CITY-LOCAL-1 153600007 Seq: 1 12/26/2015 08:10:25 Gopher State One Call Locate Request ---------------------------------------------------------------------------- Ticket Number: 153600007 Old Ticket: By: LINNEA.0 Source: VOICE Type: EMERGENCY Date: 12j26j2015 8:09:11 AM Send To: CFRDLY01 Sequence: 1 Company Information ---------------------------------------------------------------------------- CITY OF FRIDLEY Type: GOVERNMENT 6431 UNIVERSITY AVE FRIDLEY, MN 55432 Caller: 7ASON WIEHLE Caller Phone: (763) 238-8074 Contact: 7ASON WIEHLE Contact Phone: (763) 238-8074 Company Phone: (763) 572-3566 Company Fax: Company Email: Work Information ---------------------------------------------------------------------------- State: MN Work Date: 12/26/2015 8:15:00 AM County: ANOKA Done For: CITY OF FRIDLEY Place: FRIDLEY Street: 5924 5TH ST NE Intersection: 59TH AVE NE Type of Work: WATER MAIN Explosives: No Tunnel/Bore: No Right of Way: Yes Duration: 4 HOURS Remarks ---------------------------------------------------------------------------- EMERGENCY REPAIR OF WATER MAIN MARK THE FRONT HALF OF THE LOT TO INCLUDE THE ROAD ROW. SEE CREW ON SITE FOR ADDITIONAL MARKING INSTRUCTIONS. Members ---------------------------------------------------------------------------- Code Name Phone Number ---------------------------------------------------------------------------- MINGA503 CENTER POINT ENERGY - MINGA503 (800) 778-9140 CFRDLY01 �ITY OF FRIDLEY - CFRDLY01 (763) 572-3566 COMCST03 COMCAST - COMCST03 (612) 522-8141 XCEL08 XCEL ENERGY - XCEL08 (800) 848-7558 CTLMN01 CENTURYLINK - CTLQL (855) 742-6062 1