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Meter Swap '� b��J ��r�s��cda�v � INSTALLATION AUTOI�TIC.�IE��ADER G"[l'OF 1-.�.; >.. � _ , FRIDLEY . �` Address �41(� '��T:�i:�R �.ti �zr-�.. Name �,�=2:�:� ��Z\�%-�=�S Date � �'�� Oid Meter Number � .-�� , � f! • �� 41�I�I�NP�M�II�R� �I�II�I�MIit�'�AH.. Old Meter Reading �J� " l�v ` Replacement No �'� '�' �� ,�C�s, Repiacement Re �''""'�""""�"""'�""��` Repiacement Mak�'�� `��""'�"."'f ERT# 3��c� �ya�� --r Replacement ERT# ___ ,,,.�A.,.,,, Remarks: � (�� Signed: (� �� 9 ., f�equest fc�r Serviae R+epQrt • City flf Fndl�:y t��ta�: sot-�y-� r��: �o��t �ue� fj�e� k�ta�AMR n�ecer E�e�a By: w�y#�a� [?epartc��t: I�tf�er C�i��1ar�e: a�s Ad�� 141�GL�ICIER LM NE a�dc Phc�ne: 763-�71�436 "5c�teduled [3raEe= 11131'ZLFt 1 1�OD A�f� Propeifiy fl�: Loc�ir�n I7��ls: Rec�iesf Uetails. Gharx�e stappied nreter_ krst�ll AUiR A�.tican T�c�: � 1�J<P�- �'�C'`. r � � � � 1 � � ` ��'�-��- 7� y�� C��-9 ��►�:- ��r1 �C �I�t�1 i ` a�u'mr`r�� - '�� 50� � � i I��'�:!' �l �I.jC; — f� j i i ' (,'5�,� �--' ��3�0.� �. � � ' _.�____v--___ ___�.-----__--_� _ _. ._ _ __ �_ ��,��+�: - , ; `� . . ��: ��t��: ��,�� -� `�� Hiatt, Wendy From: Christiansen, Tammy Marie Sent: Tuesday, October 25, 2011 1:26 PM To: Hiatt, Wendy Subject: 1410 Glacier Ln Wendy, did you hear from Roberta Griffis about changing out her stopped meter??? If not can you call her 763-571 -4036 Tammy Christiansen City of Fridley Acctg/Data Processing Clerk/Cashier 763-572-3528 c � � �� ' � ./ V� �� (\,� V 11 1 City of Fridley Water Department 6431 University Avenue NE Fridley NIN 55432 (?63) 572-3561 Uwe hereby authorize the City of Fridley andlor 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 a11 interior plumbing. (Per City code 402.06) I also hold the City of Fridley and/or its employees harrnless for any damages that may occur while doing this operation. This to include,but not limited to; valves, piping, wa11s, floars 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: �6' � �,�/ /�Y"/ S Address: ��G C � /� C / � fZ Phone Number: �� '� �� Date: Signature: �"��G. JC-�/�` � Witness Signature: ( �"�/,��''��, � FRIDLEY CTTY CODE CHAPTER 402.WATER,STORM WATER AND SAIVITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144, 1156, 1191) 402.05. PERMIT FEE 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 cannection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting}ine unril an inspecrion 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. REPAII2S AND MAINTENANCE TO CONNECTION 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 or sewer lead has been extended to the property 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 repairs,including any necessary street repairs,at a rate set annually by an administrative 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 ensure that it remains above the finished grade of the land or property. (Ref 638, 1156, 1191) � �',� ^ , � � t t� �,_ � 'l.�` �� REQUEST FOR SERVICE REPORT CITY OF FRIDLEY Reference No. �j Date: � �� Request Type: �r— Entered By: I v�� Department: rB �\ Citizen Name:�u� v� �p IN�� - , � �tw�1o' Address: � �( C� ��o-� �0--� Phone Number: � . l � (.S� � o�r ��P�- �,Q(D p Scheduled Date. �� '� �( a� � ��3� Property Owner: Location Details: � �; � � Request Details: Action Taken: �� Responsible Person: , / Approver: Completion Date: Citizen Notified: � �. �_ � � ___._