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Meter Swap � `J 7 INSTALLATIO�� 1 v.�� AUT�MATIC METER READER F��.� G�� I �--k� Address l; �� *�`�� Name �=`�`il/ �'�l'�t� Date � '�� Old Meter Number � 3� Old Meter Reading �� Replacement No. r ��j �C�� Replacement Reading � ---► Replacement Make__�!�� ERT# c 7��%� ��G S� V Replacement ERT# Remarks: dL� ��- n.�c.� (� � Signed: � �S� . � .. � r _ �.� � � � � f �� • � , � ' "� ` „ � � ' � � � � € � � � � .. � � . � � ` ` .. " � ., � � � - �6 : � ; � � � �' � � � _ . ... ,�____._ � � , _�.._� ,w.___.__ �� -��, , � � � � ; � � � � � N • � � � � � � r � � � ' ' ' � � � � � � j � � � � � � 1 n � �„ � � i � �' � . � - � ; r , � � � � , � 3 � � � � � � �� ; � ; � � � � ; c� � , � `� �� .' . �` � , � � ; ; � � � ; � ' ' i i � .�-- � � ; - � , ` � � � � � E 3 � ; F �� 3 � a� ; � ao . ; � � � � �, � � : � � ,. .., v� � � � � � t : � � „ � ; � � k , r � , ; ; ; � � � � � � ' � � � : .� � € , � � � � � N ' ?� � � . ¢�' y� �� . � E . � 1 _� � � � . . . . . � . .. ..-. . _ ,. . f �,.� . � ) � .. . . . . . .�'.'� . . . ' ��1 45.' ,- Request Number: 6046 Public Works Division Service Request Problem Address: 6581 Centrai Av� Requested By: Patiy w/Artisan Plumbing Department: WATER �Idress: No address provided Problemlissue: TURN WATER OIVIOFF(WATER) phone Number: 612-750-3468 Scheduled Date: 2013-0424 Scheduled Time: 01:00:00 f�� n( `'�' �: ACTION NEEDED: Shut off water for repair. Leave key Permit#2013-00650"�"`BiLL*"'" Created by: Wendy Hiatt Date Created: 2013-0423 ACTION TAKEN: .................................................... .......................�.....��..�:��........C� ..—...�..�--........:..._�:::�-�.......:�-�'......_��....��.c..�'....._......._......:..._ .. ..............................................��'�...............L��......��...............�.._�._......._�:�-v�r.............�:_...�...........�--.................................:........_..._ � ....................................:�_._C��.........��...:..._�_��..�,.�Z............µ"�_��.....��...............................................................�........_._.._........._.._......................_......_ _......................................................................................................................................................._..........................................................................................................................................................................................._......................................___......_............. ..............:........................................_................................................................._................................................................................................................................................................................................................................._................_........._..__-___..._......._ ...................................................._........................................................................_......._...._....__.._................................_...........................:.........................................:..._........................................_.__....................................._......_......._..............._.................. Status: In Progress Resident Contacted ❑ Date Completed: Comple by: . � _ �,�- I � J � �^ �� J � � � � � � € � O � � ; �-� � T � � � � ' � �� -� � � � v � i � � � � � � � � � � � � � € i �. � � � � � ��- � � � ; � � � � i � � � � � � � � � �� E � �-- � ; oc � � � � �' � � � � � � �` � � � � � � � � � � � _.____ �, �. � ! � : � �. �� r __ �__ � ° ' � � � ,�' C � i,, � ; � � � � i � 3 E � r-- � c� ; j W �� , � i� ; �� ` � � � ' � i . � � � � � j� �) � ' � ; ; � � � � � � � � � � i � � � � � � " � � ' i (� i ` � r � � , ; � � � � � � ( ' � � � �� 1� . j � �� ; � �� i ai .: � � � '� � � ;i; �'` � a� � c� i � � � � �r. ° � cl � � " � r5 9 I � � _ _ � � � __. ... .... __. , y � City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe 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 understand that the property owner is liable far 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 harmless 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 u.nderstand I am also required to obta.in a permit prior to any work. �� Na.me:L,�N i�C� ��G�+rS v�P.sS Address: �vS�� Cc��.�'�,ra � �'� ��' Phone Number: 'S �— •� — O �C�{� Date: ( �t 3 I 'Za I J Signature: Witness Signature: FRIDLEY CITY CODE CHAPTER 402.WATER,5TORM WATER AND SANITARY SEWER ADMIlVISTRATION (Ref Ord No 1 li,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 applicarion 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 woric incident thereto has been approved by the City as a proper and siritable 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 e�ended 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 conneciion 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 ra#e 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 inc]uding 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 ofthe land or property. (Ref 638, 1156, 1191)