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'� .�a- t��'a�s--�s��s� � � INSTALLATtON ��.�� AUTOMATIC METER READER FRIDLEY Address �� "" s� � ( Name l.��J'TI��A �..:�Cr�i.�'�2 Date i �-���� Old Meter Number � ���b Old Meter Reading Replacement Na .� �a �� Replacement Reading Q� 0 Replacement Make_����� ERT# �_�{��� l � Replacement ERT# Remarks: (p3 3y Signed: _ —v � Requ+e�t f+�r S�r�e Report � City of Frid�:y ; ����rm�: ��-�t-:�s ���: ��.rz�o» t� �,�: ����wR�� r��a�: w�ty�� [�p�n+�: Vti((at� Ckizeri�lame: C3�rtFua VM� Addreas� 6821 6TH ST NE aek Phcsr�e: 763-�72-9523 Sc�uled D�e= t lfll�i}l1 2�I0 PM Praperty�v�mer: �����,r��: �,�d . � o�c�i�� r.��n a�R a.�s�,T��: � �i'J 1; �''lr � r��� E � i [ � ( � o�o �z -- 0 ��� ��� � 3� 7 ���� f�� ��._ �S��Q� � �,�� �1���� - y3����C� ti��c,� 2�1��►1�-- � ` � � �33���I� Respc�r��e P�,: , .�, ' � �flV�: _ _ C4tnpletiQfl I7at�e: . �C#Zert hlotfied 1 �-�- �� _ , . City of�'ndlzTl �irTate�De�artm.eni 5��1 L?�versity�venue 1���. F�iciley�i�'�T 5���2 , �ib�� J7Z-�J�bl Uwe �1 �'1�\t� �%,/-��-�ci✓ he�e�z aut�o��:, th� Ciri oz F��ley a.�d/or irs . employe�s ifl c�a ��at��ev;,ssarv to_�plac��.he waier me�e�-_ _T_unde�st�nd thai i.�e prope:.iy o�ner is liahle ioz ihe w�ter line f�or������t� t��p�e���, ��� ;��yror �Iu�bi��- ('��r�i� cade?Q2.0� 1�sfl '�old�e City of Fridley and�`or i-cs e�lo;retis �ar�lPss ior any damaQes t�aL ii�'73lT Oi;�13i wJ_LL.1� i�O771C t31is operation_ This to incl-a��.but noi 1i�nite�.to; valves, pip�g, wa1L�, f���s or t;3e c•�� stop b�n and se�iice line. 1 LndersrQnc� I am �.lsa zequ;re�.to Dota.;n a�v1LL1�y i_O� I.11 �IlJF 'vY VT� �11a..v�ssa.ry. (, C ° ��ame:�� l��'i IC��ti,�l�✓. _���Ess:�l_j2. I `F� ������ 1 h�ne l�umber:��' S ��Z �1�� 3 Date: � � �� �Z 47/ � � l�� S1P'J1a��. l� • '� J1 _ � ��\ �i1T1tL�SS .�"�.1�at11I':.: i+�'�T�� .�v���'Y���� - - �'��`�'���p?.3;�I�.1v�,�����T�Y���T�`��i� �.�2���:��S��� s����������r (kei Ordi�T-0 lli, 15�, 5ti�, �oo, 0'2�,o�o, 50?, 92?,°$8, 1111, 11��, 1191) �1�?.9�. �'�'��'i�+y, , Prar to cansu-uc�ug or rep�ir oi any zuaie;or sewer_line conneciiug the e<,isting municipal system and any hous�or�uiIdin�_or�Ahicn��e a�pl�cation is m�de,the o�r-it�r or caniractor shall be re:�u3redto oo'ra,in a pemii for such connea�ian, a�d shzll pa�a pernii fee as provide�i i� CIlantcr 11 oi-i�is Code_ _�frer�such cannzc�nn has been�ade��he Watzr on�Sztiye��epa�-tmeni a�all be no�e� i#shall�e u�tawnii tL co��er any ccnneL�n�iine until an iuspection has oeen,�ade and su�h conne�tion and the wor3�i��ideni;.�ereto has been a�oproUed by�e Ci�r as a prooer�d saitable cnnne�-tion_ =�02.{��3. i��i_��i1��t'�I�i�_11"�'3'1�'+,1�1 d_1''T�:i.�'� ���Ir'�i��'��� ���e;the ia�ual con3�ii�n�as be�n�ade to�;,�y3rer servic� c�,�-b s�op bon or�he�ewer lead`F t�e proper�T lina�or a�?atz:serSrca 3r seu7er'ead�as b�en z.�r�ndefl io ihe pr��-ty;ine_f�r eannec+�o�; ��,.e applicani, owner, or the occup�ni or user�i suc��rzmises shall'�e liable Tar aii zz��rs izq�-e�to any water line and any sewer]iues netiessat�for co�n�ction pl�e premises Trom�e main Tta �.he prem�es. If - the nroperiy o��er re�ueszs main�ez�ce se;�rices or re�,ais�a perzormed'oy The �iiy,�e proper�y ow�e< shall be c�ar�eci ior�e costs of�h.,mainte�ancv a�d/or��a;�-s, inc��dinJ any ne�ess��sireet repairs,at a rate set�ua11y oY an 3cim]�i,sTsaiisa�olicy. I�sha31��the respLnsibi?it�r ofthe aD�3�c�t, �ti�uer, oc�upanT or us�:to pezi�rm st�d�-d manizuance Qz he sesver s�rvice.'�e frflm t3�e p�e�ises ro the�ain�ncludi�g de'�is cl-QaL-ing or r�ot cu�a�d to mainia�n t.�e wat�r s�rric� curb si�p b�n i�r oper�.bilii;��d at sucn hei�t us�rill ens�re�at;t rem�s a�a��i}ie finis�ea�ade oi�.i.e lzad or�rop�riv. ��i 534, 1���, 11��':j Request Number: 8929 Public Works Division Service Request Problem Address: 6021 6th St Requested By: Joe Weber Department: WATER Address: No address provided Problem/Issue: STANDPII'E Phone Number: 763-300-5761 SchedWed Date: Scheduled Tfine: ACTION NEEDED:Homeowner is having driveway replaced and it will be lovver than existing driveway.He needs standpipe lowered approximately 8 inches.He has it staked out. Created by: Wendy Hiatt Date Created: 2014-09-17 ACTION TAI�N: �� � � � � .............................................................................:...... ............ ..........................:...............................:.............................................t�����........�....................._._..._........._._..._._..___.............._..........__.___...._._....._....... ............................................................................................................................................................................................................................................................................................................................_.................._....................................___.._.__.._.... ........................................................................................................................................................................................................................................................................................................................_._................_..............................................._._............�...... ................................................................................................................................................................................................_......................................................................................................................._._.........................................................._.....__............_.._._ .................:.................................................................................................................................................................................................................................................................................................................................................................................................._ .....................................................................................................................................................:................................................................................................................................._........_................................................._................................................................_ Status: In Progress Resident Contacted � Date Completed: Comp[eted by: �� '����