Untitled Req uest N u m ber: 7048
Public Works Division
Service Request
� ProblemAddress: 6719 Jackson St Requested By: Nicole Braun
Department: WA"{"ER Address: No address provided
Problemlissue: INSTALL METER(WATER) Phone Number: 612-270-9432
Scheduled Date: 2013-10-03 _ n Scheduled Time: 11:00:00
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ACTION NEEDED: 2013 AMR �
Created by: Wendy Hiatt Date Created: 2013-09-25
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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_ City of Fridley
Water Department
6431 University Avenue NE
- Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of�ridiey and/or its oWner
employees to do what is necessary to replace the water meter. 1 understand that the propertli
is liable for the water line from the main to the premise and all interioan�damiages that ma yoccur
402.06) I also hold the City of Fridley and/its employees harmless for Yln ���s,floors or the curb
while doing this operation. This to include,but not limited to;valves,pip' g►
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary. � ! �+'�/�'�
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Final meter reading(old meter) ��� � C,/�
Address' L'�
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Name• •
Phone Number: Date: ����_—�----'
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Signature: s
�tness Signature:
FRIDLEY GTY CODE
CHAPTER 402.WATER.STORM WAT�R,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Na 113,464,565,566,629,638,662,922,988�1144�1156,1191} _
402.05.PERMIT FEE
Prior to constructing or repair of any water vr sewer line connecti�go shall ben equir'edto�ob ain a permit for such
or building for which the application is made,the owner or contract
connection,and shall pay a permit fee as Phall be not fed.tlt halt be unlawful to cover any c nneicti g 1►neeuntil an
made,the Water and Sewer Department s roved by the City as a
inspection has been made and such cannection and the work incident thereto has been app
proper and suitable connection.
402A6.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service�o�e�0p�ne forrconnec oni the app cant owner,
line or a water service or sewer lead has been extended to the p p rtY
or the occupant or user of such premises shali be liable for all repairs required to any wate��ne �edUe�er lines
necessary for connection of ihs�Pee erformed by the Citytthe p operty owne shali be charged for he costs of the
maintenance service or repa p an administrative
maintenance and/ar�epairs, includ'��nf the anplicasntr ownert occupant or user to perform standard maintenance af
policy. It shall be the responsibil�ty P
• the sewer service line from the premises to th�at such he gh as w II e sure hat i ma ns abo e the fin shed e
water service cur6 stop box for operability and
grade of the land or properly. (Ref 638,1156,1191)