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Meter Swap �� l�-U I�5-Y�ivy�� � ��"`��1 INSTALLATION G.n� AUTOMATIC METER READER FRIDLEY Address 1(� 2�`�1� ��. �� Name ���� ����'� Date � l �'�-V '� � Old Meter Number .� � � Old Meter Reading � � Replacement No. �a Replacement Reading � Replacement Make � ERT# � �{C3� � � Replacement ERT# Remarks: Q.�3�] Signed: Requ+est fQr �rv�ce Report . �ity of Frid� f�F�renc�fi�: �1-Z 1-3'�07 i}�e: 11'I28J2'�1� R� Tppe� T�n water afflon Erd�eci By: W�dy l��# Qe�a . Water t:�iz�N�e: F�k w/7{�'s Adckess� 482 RICE CREEMM�TER NE C�adc Ptro�+e: 763-493-�D s��a �c�: �j�rzo» �:����--� ��S , P�c�: pc��� �7G�'� ��� �� �l� Loca�icx,��s: ""B��.L"" � neta�s: shut ,rr�teF off-le�►e ke�r Pexrr�T##2011-02'fi�4 ���� ��.1��Cv� ,�T��,: ; �� v� w��� a �F �-�� 1�� i I , -(� �J� K�-� � �G�N � �<<� � N`����,--� ���Z ������ ���= . ; l ! � � � E � G , ; �- � - 33��73�� ; ���� � ; i � � �c� �-���(� - `�D �c7 ' i �}._ c.{ ! � ��� ��� �s�la�g ; ' �� ����� � ; , � � � �-�� ��a�6�o � � 4 _ _ _ _ . _ __ . ___ _ � �,�P�: ��: _ _ _ c���: � _ �, 1 � I�c�;��r�a � _ __ , � (� ,. ' City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to shut off the water at the curb stop box. I understarid that the property owner is liable for the water line from the main to the premise. (Per City code 402.06) I also hold the City of Fridley and/or its employees hannless for any damages that may occur while doing this operation. This to include, but not limited to, � sod, yard, landscaping,trees, shrubs, driveways, sidewalks or the curb stop box and service line. I understand I am also required to obtain a permit prior to any work. Name: Address: �'�,�. ��CE �N� � E�2 Phone Number: Date: � , � , Signature:� t � i `-., ��, 1 l�� j '� �� Witness Signature: �- FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY 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 e�cisting municipal system and any house or building for which the application is made,the owner or contractor shall be required to obtam 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 agproved by the City as a proper and suitable connection. 402.06. REPAIRS AND MAINTENANCE TO CONNECTION Af�er 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) � Request for Service Report City of Fridley Reference No: 601-11-3906 Date: 11/28/11 Request Type: Turn water aPFlon Enkered By: Wendy Hiatt Deparkment: Water Citizen Name: Rick w!Kal's Plumbing Address: 482 RICE CREEK TER NE Callback Phone: 763-493-2060 Scheduled Date: �� ��,11 f� ,� '�j(j'"'r�Qs , Property Owner: Location Details: Permit#2011-02664 Request Details= Shut oFF water - learre key "'"B I LL""x` Action Taken: Responsible Person: . F2�quest f+�r Serv�e R�p�or# �ity of Fridley t��ce t�a: �-12-�4�'Oa t?ace: 1l1ot2�d12 Request T�e� TY seirer�fir�e Errt�reci�j. W�uly k�t �artme�: 5ern� t�ixe�►V�e: Jaao�Kanop� Ad�� 482 RICE GFtEEK 7ER NE Ca�ad�c�e: fi12-7t�9-6d�3 S�duled Date_ 1/11/2t►1�"2:#i�FIYI ,�L'�' P�()wn�: L.�ca#ic�n t��s: � D�eta�s: 7�Sewer Ser��cx Ac�icm T�: ° l--� -S i, i ����u=z_ �.--�t�rz ����t�5�� � ��o o�'`��LT' i ? ' � � �-�' av� ��&- � ��"'_ i �p�� � �,�(���.��v � I � I I i � � � � , r �����,: ���_� �� � . 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