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• City of Fridfey
, Water Qepartment _
6431 University Avenue NE
Fridley,MN 55432
(763)572-3565
��We hereby authorize the City of Fridfey and/or its
employees to do what is necessary to repface the water meter. t understand that the property owner
is liable for the water line fram the main to the premise and ati ir►terior plumbing. (Per City code
402.06) I also hold the Gty of Fridley and/its empioyees harmiess for any damages that may occur
whife doing this operation. This to inctude,but not iimited to;vaives,piping,walis,floors or the curb
stop box and service line. 1 understand i am a{so required to obtain a permit priar to any work,if
necessary. ��� � ��
�inal meter reading(old meter)
Name• Address• � � �� �T .�.---
Phone Number• Date� �/�'` -
5lgnature: `
�tness Signatu�e:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,538,662,922,988, 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
connectiQn,and shalt pay a permit fee as provided in Chapter 11 of this Code. Afte�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 suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai 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 connectian,the applicant,owner,
or the occupant or user of such premises shalf be liable for all repairs required to any water iine and sewer lines
necessary for connection of the premises from the main to the premises. lf the prope[ty 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, incfuding any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,accupant or user to perform standard maintenance of
° the sewer service line from the premises to the main including debris cfearing or root cutting and to maintain the
water service curb stop box for operabitity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j