Meter Swap '� ���,� � "��ia-s-Y��"���
� INSTALLATION
��.N� AUTOMATIC METER READER
FRIDLEY
Address "���� �J����
Name ���1� �C�ir�l-te��
Date � d� ''L����
Old Meter Number � �,7��
Old Meter Reading � �
ReplacementNa � � t ��y�
Replacement Reading �
Replacement Make �.��
ERT# �� .7���c�� �.
Rep{acement ERT#
Remarks:
�,�� Signed:
F+teqt�es# f+r��n� Ft�art�
. - �y►t�f Fnd�
�€��_ ��-��-�t�t �: �z�r�2���
�Tjl�e: hst���- �+�f�r�
t� . wa� � �Ar�e
A�dd�: 5�98 ST i� � �-7�s7
S�d fl�e: 1�/1�t17 7 11_�L1/1ii1 � �y�:
t�[d�tar�: ��eat 0eia�s: �ll��i
Ta�=
1
�,5�� ���,N�
ex�m�- �3`S�-�a�1
a���o��- ���.� ��d
�����-� - �35�a�'�'�
,��-� t�-��►x� - �j
�.cz{ � — 33�3 5�1
� �
���� �
�...__ .. _. _._________.__--___.--- --._.
�
�___.._______�__.__�__ .____�______ �______ ___._.___.___ __._._____
��. , � � � ���
i
� �� �____ _ _m. ._ ..��_ � �
Ci#y of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. i understand that the property cwner
is liable for the water line from the main to the premise and ail interior plumbing. (Per City code
402.06j I also hold the City of Fridiey and/its empioyees harmless for any dama�es that may occur
while doing this operation. 7h1s to inciude,but not limited to;valves.piping,walls,floors or the curb
stop box and service line. 1 understand i am aiso required to obtain a permit prior to any work,if
necessary.
r r adin otd meter � � �O
Fina(mete e S( )
Name: Address: ���t5 ��
Phane Numbe Date: `r— �—�
Signature: �
Witness Signature: ���
� FRIDLEY GTY CODE
CHAPTER 402.WATER,S70RM WATER,AND SANITARY SEWER.
ADMiNiSTRATION
(Ref Ord No 113,464,565,556,629,638,662,922,988,1144, 1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water ar sewer line connecting the existing municipal system and any house
or building for which the apptication is made,the owner or contractor shall be required to abtain a permit for such
connection,and shall pay a permit fee as provided in Chapte�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 untit an
inspection has been made and such connection and the work incident thereto has been approved by the Cfty as a
proper and suitable connection.
402.06. REPA{RS 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 tothe property line for connection,the applicant,owner,
or the occupant or user af such premises shall be liable for all repairs required to arty water line and sewe�lines
necessary for connection of the p�emises from the main to the premises. If the property owner requests
maintenance service 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 annua{{y by an administrative
policy. It shall be the responsi6ility 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 Fnished
grade of the tand or property. (Ref 638,1156,1191j
R�q�t for Sa�rvice R�port
. City nf Fntiley
t��,��o: �at-rti-�� a��: �1 t�
Requeat Tppe� (rrstafl /1MR met� 5rtened 83r: VIFe�+��i
f}+�partm€�rt: Water C�ix�Marr�e: M�y Arm Le�er
Adckess� 5798 JEFFERSUN ST NE C�adc Phvne: 7fi3-��i4-�7
Sc�eduled Date: 1Z�7/�11 1:OQ FI�1 �� ` Pmperty(hm�:
Loca�on D��s: ��est D�eta�a= kntaY AMR
;4��n T�en:
�
� l
� ��
�
� �
C �
� . ,
: � �� �
� �
� �
�
�
. � �
� , �
�
. �
3
�
__ _ _ _ _ __ _ __ � �_� __ __�_._______ a
�� �
�,�P�: �
���:
- r��r�: � � r.�-�►r�
;
. �
Request Number: 8392
Public Works Division
Service Request
Problem Address: 5798 Jefferson St Requested By: Holly w/Plumb Rite
Department: WATER Address: No address provided
Problemlissue: TURN WATER ON/OFF Phone Number: 763-561-3306
Scheduled D�te: 201407-1 � Scheduled Time: 08:30:00
�'
ACTION NEEDED: Tum of water for repair. Leave key. "**'BILL*""'" Permit# �'tf���1�
d-
Created by: Wendy'°Wi�#G Date Created: 201407-10
�,,
ACTION TAKEN:
..................,............................................................:...................................................................................................................................................................................................,......................_.........................._............................_..._..._..........._.............._.....
.
.....................Uv`......._0.:.��-e:.........................:�:o.........................._�..._�'�,_�f...........................................1..�_:�r..................:.........._�..._��`...................................
S�f o � � r10°�
l�l.:�:........................:..............c.�...�....�................._...............�_".:�.b.�....,........................�_�_�.._b............................................�..................�...Q.............�............._.._.............................................._
�-�..r�^....�...............:.....................:............::........_.........................................................................................................................................................................................................................:............................._........................:........................................
.................................................................................................................................................................................................................................................................................................................................................................................................................
....................................................................................................................................:.........................................................................................................................................................................................................................................................._.._......._
Status: In Progress Resident Contacted `�
/
Date Completed: Completed by: ;
�
f� � � � ' �