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Meter Swap ,�,�.;�' �y-�,�'„` `.��,,�-��/C:i �., � ' � INSTALLATION u.�� AUTOMA�IC METER READER FRIDLEY Address `i�r� �F— Name �� `�+41.� Date (c�� «� � c� Oid Meter Number �?��V�� OId Meter Reading �� Replacement No. $� �C�L '�J Replacement Reading Q� � Replacement Make ERT# �� C�� 'l,k� P Replacement ERT# Remarks: �� Signed• ��t1�� fi+[?�'�Ili►It�: ��If� . ��y cxf Fndl�y ��: ��-�� : ��z �T�� r: u��c . w� t��: ��+r� A�: 871 �[�1tE�W' . 4�12�18�8U49 S�ied[l�te: Gf19u�Q11�2-.3d P#i �� t)wrner� . R�u�I�S: �i1R Ac�ara Tair�� t�ld �let�;r# `�j�(�� Id r�a�din�. ��`� �� J��v M��r# �--.��j � 8[ � �ew Readir�g. � ��o E�� `��Q a � �� __e__... __�.��_ ___._.,...._.�_____ � � � � � �.._:__�� . ___ _ _____�_._____._ �: l �� _ ___� _ City 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 owner is liable for the water line from the main to the premise and all interior plumhing. (Per City code 40Z.06) i aiso hold the City of Fridley and/its empfoyees harmless for any damages that may occur while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb stop box and service line. i understand I am also required tu obtain a permit prior ta any work,if necessary. Final meter reading(old meter) � � �-/'�-� Name: Address: �.�' '' ""Q� �'�t" " ` _ Phone Number: Date: �� — `� � Signature: IJ (lu��-- . Witness Signature: FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER�AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,6�9,638,662,422,988,1144,1156,1191) 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house or 6uilding for which the application is made,the owner or contractor shall 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 until an inspection has 6een made and such connection and the wark incident thereto has been approved by the City as a proper and suitable connection. 482.05. REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop 6ox or the sewer lead at the property line or a water senrice 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 sewer lines . necessary far 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 cha�ged for the costs of the maintenance and/or repairs, including any necessary street repairs;at a rate set annualty by an administrative policy. It shall be the responsibility of the applicant,owner,occupant or user to pe�Form 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'#or operability and at such height as will ensure that it remains above the finished grade of the land or properCy. (Ref 638,1156,1191� . , . Request for Ser�rice Report , City of Fridley Reference No: 601-11-2765 Date: 011lllll Requexk Type: Turn water oFFfon Entered By: Wendy Hiatt Department: Water Citizen Name: Tom Gale Address: 871 MOORE LAKE DR W Callback Phone: 612-518-8049 Scheduled Dake= O1112111 7:3U AM �� Property Owner. Location Details: x"'BILL"" Request Details_ Turn waker an Action T aken: ,..._.______.__..____._----- _ _. U2�� C�-' V��- � R esponsible Person: � �� . ____�� _. +�RRrouer: Complekion Date: I ��1 1 �Citizen Notified � Req uest N u m ber: 7399 Public Works Division Service Request Problem Address: 871 W Moore Lake Dr Requested By: Tom Gale Department: WATER Address: No address providecl Problemllssue: TURN WATER OWOFF(WATER) Phone Number: 651-2418-1472 Scheduled Date: 201401-15 Scheduled Time: ACTION NEEDED: Shut water off at street and leav�e key by front steps. Nobody home and no bck box Told him we couldn't be sure water was off 100%without going into home. """BILL**"` Created by: Wendy Hiatt Date Created: 201401-15 ACTION TAKEN: ..........................................................��a�'�....._��..........._w._�--��..........._�:.�..........L.,�--�..:-�...._....�.�........�_...�:..___.__.___.._...............................__ _.....................:..................................:.....�..�...�........_�_��.....�.�........_�..�.........:..�-7................��_�.............................................................._........................:............................:........................_ .............................................................................................:........................................................................................................................................................................................................................................_......................._...................................._.....:............. _............................................................................................................................................................................................................................................................................................................................................................................._..._....._............................... ..............................................................................................................................................................................................................................................................................................................................................................................................._._..... _.........................................................................................................................................:......................................................................................................................................................_..........._.............................._.........._......._..................................................... Status: In Progress Resident Contacted ❑ Date Completed: Completed by: l- I �-�t-( ,