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Meter Swap '� �>>—�� I�i��s—Y�o�v INSTALLATION ��. AUTOMATIC METER READER FRIDLEY Address ,�_�� 5�� ( Name ��f�M�C% �ttPs�,2l�a Date �c�,b (� J Old Meter Number �l �� Old Meter Reading �-i Replacement No. �� aaa� Replacement Reading� Replacement Make�� ERT# �3� ��,� � Replacement ERT# Remarks: ��.� Signed: � ' � R�q�t f�r "�ervic� F�t�pc�r# !�ity c�f �nd� � r�: ��-�2 ��: ��2 �T�� r��;�� +�� : w� e� . �aa�� t��s�ss��sr� �: �-z�z.a�� tl�te= 3�26lZ�1��:30/1�i � _ l�[l�#�: t�: � A,�Ta�: �id �"le�er# �`l Cj� � �6 ��id readir��: �l� C� � `� 3� ��,� �� 3�q aaa3 �#+�vu► R+�ading: � ��T� 3��1 oS� S �� ! �_._�_�_� �__ _.__.�_.._�_________�:__.._._____ � � � � ; ��__.__.__ ___��._�_ ____.____---______ _ _� _ ..__.__ ��: � � �,�� - - . _ �� ._�. __-C�_ .�c� _ ._ City of Fridiey Water Department 6431 University Avenue NE Fridley, MN 55432 (763)572-3566 liwe 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 owner is liabie for the water line from the main to the premise and all interior plumbing. �Per City code 402.06) i alsa hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited ta;valves,piping,walls,floors or the curb � stop box and service line. I understand I am also required to obtain a permit prior to any work,if necessary. ' al t r t r � �� F�n me e rea�ing(�li me e ) � Name� Address� �� l 4��` �� Phone Number. Date: �—�� Sign � Witness Signature: . FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMIN ISTRATION (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 buiiding for which the application is made,the owner or contractor shall be required to obtain a permit for such conneetion,and shaN pay a permit fee as provided in Chapter 11 of this Code. After such connectian 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 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 sewe�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 iiable 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 shali 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 inctuding debris clearing o��oot 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 properiy. (Ref 638,1156,1191� ' , 7,��%7 _ �.;3 ' � i'''�"%�i;l;%� Request for Service Repork -, ,;-� : . City of Fndley �l.A ,��. Referer�ce No: 601-11-2757 Date: 01/06/11 Request Type: Turn water aFflon Entered By: Wendy Hiatt Department: Water Citizen Name: Jimmy Harris Address: 574 MISSISSIPPI ST NE Callback Phone: 763-222-4175 Scheduled Date= Ull07I71 10:00 AM � � Property Owner: Location Details: Leave key in standpipe Requexk Details_ Shut water oFF_ Leave key """B I LLx"" Action Taken: �_�..____.__._. ..�. _._ _. .__.__.____._._._...... _�.._______ __ � .S ��- �v'�.-�-e r o -� � � � C�� S-�-v� �-��'+ �� Y �,,: �� I� � � r�e v�,n�.r � Responsible Person: ' Approver: Completion Date: � �Citizen Notified � � _ � � � x . City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 � f . �'a + I i...' ;- . I/we + . =t ��n� �. ��, y � 1 hereby authorize the Ciiy of Fridley andlor its employees to do what is necessary to shut off the water at the curb stop box. I understa�d that the property owner is liable for the water li.ne 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 understand I am also required to obtai.n a permit prior to any work. � � � � Name: �.,' 11'h i'�1�~'� \�(��i Address:_�1 � ��SSI SS( �f�l S�� J V� . � Phone Number: � Date: j � ?�— �o ( � Signatur �� Witness Signature: ��'��%� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SAlvITARY 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 obtam a permit for such connection,and shalt pay a permit fee as provided in Chapter 11 of this Code. Af�er 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 approved by the City as a proper and siritable connection. 402.06. REPAIl2S AND MAINTENANCE TO CONNECTI�N After the initial connection has been made to the water service curb stop bax 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 administrarive policy. It shall be the responsibility of the applicant, owner,occupant or user to`perform standard maintenance of the sewer service line fram 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 properry: (Ref 638, 1156, 1191j