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- City of Fridley �r'��� (_,/ ���
Water Department � �
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6431 University Avenue NE �
Fridley,MN 55432 ��i �/ ��. �
(763)572-3566 1� . `1 �
��We hereby authorize the City af Fridiey and/or its
employees to do what is necessary to reptace the water meter. i understand that tfie property owner
is liabie for the water line from the main ta the premise and ail interiar plumbing. (Per Cit1i ccde
402.06) I aiso hold the City of Fridley andJits emptoyees harmfess for any da�nages that may occur
while doing this operation. This to include,but not iimited to;vaives,piping,waNs,floors or the curb
stap box and service line. i understand 1 am also required to obtain a permit qrior to any work,if �
necessary. '��:
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finaf ineter reading(ofd meter} ,
Name: I�Y� ���-� _Address• ��t/`� G�` ^-��Z�_
Phone Number Date• �v� 1 �V ' �
Signature:
Witness Signature: �
FRIDLEY GITY CaDE
CHAP'TER 402-WATER,STORM WATER,AND SANtTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156,1191j
402.05. PERM17 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 appiication is made,the owner or contractor shali be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shali be notified. It shall be uolawful to cover any connecting Iine until an
inspection has been made and such cor►nection and the work incident thereto has been approved by the City as a
proper and suitabte cannedion. �
,y
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 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 liabie for atl repairs required to any water line and sewer 4ines
necessary for connection of the premises from the main to the premises. 1f the property owner requests
maintenance service or�epairs be performed by the City,the property ouvner 5ha11 be charged for the costs of the
maintenance andJor repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. 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 including debris clearing or root cutting and to maintain the
water service curb s#op box for operability and at such height as will ensure that it remains above the finished
grade af the land or property. (Ref 638,1156,1191}
d<a:
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Request Number: 9328
Public Works Division
Service Request
Problem Address: 6421 East Ri�r Road Requested By: Jessica in Billing
Department: WATER Address: No address provided
Problem/Lssue: FINAL METER READING Phone Number:
Scheduled Date: 2014-10-31 SchedWed 1Time:
ACTiON NEEDED:Closing on 10/31/14,we will need to get final reading please.Ert#351�72443
Created by: Jeannie Benson Date Created: 2Q 14-10-30
ACTION TAI�N: -
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5tatus: In Progress Resident Contacted ❑
Date Completed: / Completed by:
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