Meter Swap '� ����� 3��:��-y���"�v
� � INSTALLATION
�.N� AUTOMATIC METER READER
ERIDLEY
Address t[7�� �7 �v�-�� L�
Name i`� ��� �2� ��C�AG�f'Z(�
Date ����(o�
Oid Meter Number �
Old Meter Reading L
Replacement No. i �
Replacement Reading�
Replacement Make A ro .
ERT# ������ "
Replacement ERT#
Remarks
�D`�S Signed:
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' � City of Fridley
Water Department
6431 University Avenue NE
' Fridtey,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/o�its
employees to do what is necessary to replace the water meter. i understand that the properly owner
is tiabie for the water line from the main to the premise and ali interior plumbing, (Pe�City code
402.06) 1 also hold the City of Fridley and/its empioyees ha�mless for any damages that may occur
while doing this operation. This to incivae,but not limited to;valves,piping,walls,flooirs or the curb
� stop bax and service line. i understand I am aiso required to obtain a permit prior to any work,if
necessary. �� ��n �
«� �
Final meter reading(oid meter)
1
Name: a Address����� �-^V L\� �
Phone Number:
� ate• 1,�' —� l�
5ignature:
_ �tness Signature: .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER "
ADMIN ISTRA?ION
(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 shail 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 connection has been
made,the Water and Sewer Department shall be notified: It shall be unlawful to cover any connecting line untii an
inspection 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. REPAIRS 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 o�sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liabie for all repairs required to any water line and sewer lines
necessary for connection of the premises 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 annualiy by an administrative
policy. It shall be the responsibifity of the applicant,owner,occupant ar user to perform standard maintenance of
the sewer service line from the premises to the main inciuding debris cfearing or root cutting and to maintain the
water service curb stop box for ope�ability and at such height as will ensure that it�emains above the finished
, .
grade of the land or property. (Ref 638,1156,1191) -
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REQUEST FOR SERVICE REPORT
CITY OF FRIDLEY
Reference No. Date: ��-�- i3
�r^ � _ w
Request Type: � U r� O� ��\ Entered By:
, � A ,
Department: �a�l Citizen Name: ���
Address: (.,5�J�o 5 1.��� � Phone Number: � a
�a n so t �,3
Scheduled Date: ��-�UU-l3 � � '.(�(�P�n Property Owner:
Location Detailr. Request Details:
Action Taken:
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Responsible Person:
Approver:
Completion Date: �-��-��� Citizen Notified:
�
.
.
Request Number: 7242
Public Works Division
Service Request
Problem A�ddress: 6565 Lucia Lane Requested By: Mike
Department: WATER Address: No address provided
Problemllssue: TURN WATER ONlOFF Phone Number: 612-750-1263
Scheduied Date: 2013-11-20 Scheduled Time: 01:00:00
ACTION NEEDED: Turn off water and leave key. Leaky vaMe being replaced. *"''*BILL"`***
Created by: Wendy Hiatt Date Created: 2013-11-20
ACTION TAKEN:
......................................................................................,......................................................................................................................................................................................................._...................................................._..........................._.___...............,..........
_.........:.............................................................................................__.......__......_..................................................................................................................................................................................................................__._............_._.:_............:......_........_..._
................................................................................................................................................�..._..........................................................................................._,...............:..................:...........................................,............................:.............................__......................
_.............................................................................................................................................................................................................................................................._.................................................................................._._................_............................_...._......_..
..............................................................................................................................................................................................................................�....._....._.._._......_......_.............__.._.............._............................................................._....___..._......................
Status: In Progress Resident Contacted �
Date Completed: Completed by:
Hours
�1/'
Request Number: 7231
Public Wa�ks Division
Service Request
Problem Address: 6565 Lucia Lane Requested By: Nkke Gross
Department: WATER /�ddress: No address provided
Problemllssue: TURIV WATER�IlOFF(WATER) Phone Number: 571-7756
Scheduled Date: 2013-11-18 Scheduled Time:
ACTION NEEDED: Emergency water shut off.Advised him to puN permit before water wauld be iurned back on.
� ��� �
Created by: Wendy F�att Date Created: 2013�11-18
ACTION TAKEN:
._.._..__._._........._.._...............................���..._r._�..oT.-=.�-......_�_��"�:...._.�N.c..�......_.._1.-���_(�:�._.._._........._..___.__........_..._..._._._.
..._....................._......_.........__....................................�.�......._����.._.....v......_.�.....!��.....�T........_1....��....._..............................:...._..........__..____ _.__._._._......._.._..._
Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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