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��"�� hereb�ascthorize the City of�FnidPey and/or its emp�oyees to�lo what is asecQssary t,
r��taca the wat2r�netec. !�araderstand that�e property o+aner is 9iable for the avater line from the main to the prerrtise and all�rrterior
�iuraibing. (Per�City sode 40Z.06� !a(so hold the�it�y of Fa�dley artdJ'�ts emp9oyees haranless for arry dare�ages that may accur while doing thi;
o�aeration. This to�rtclude,but not 4imited to v�ives,pipirsg,walls,floors ar fihe curb stop bo�c and service fine. in understand 1 am also�equi
to aiatain a permit preor to any wof4c,'sF�necessary.
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Name•- �1 pddress lSL �_'� �
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. Phone Number � �� i���` ��� � � �� — + �
Signature '"�.—
Witness Signature
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FR[DLEY C1TY CODE
CHAP'CEIt QOZ.WATElt,ST�Rf1►1 WATER AND S�INHTAR1f SE�A/ER
�ADMINISTRATION
(��Ord N�i13,4C4,,65,56FsD 629,638,862,922,988, 1144,1156,1199.j
402.5 PEliMlT PEE
� Ps�iar to constriscting ar repair of any water of sewer dins connecting the existing municipa(system and any house or bu�lding for which the
application is made,the awner or contractor shaii be required to obtain a permit for such connecCion,and shail pay a permit fee as provided ir
Chapter 11 of this�ode. After such connection has�aeen made,the Water and Sewer Departmerrt shail be notified. It shall be unlawfut to caw
a�y connecting i�ne s�ntil an inspettion has been roade and such connection and dte wark incident ti�ereto has beert approved 6y#he Gty as a
g�raper and suitable connection.
402.06 1tEPAiRS As�tD 1►etA1PITEPiANCE TO CONNECTIOIY
A�Fter tPae initial sonnection has been rrsade to the arater seruice curb sCop hvx er the sewer lead at ttie prc�perty line or a urater service 9ead has
been exfiended to the property line for connection,the applicarrt,owner,or occuparrt or user af such premises shall be liable for afl repairs
required to any water(iae and server(ines necessary for connectiora o#the premises from the main to the premises. (f the property awoer
rec{uests rttairrtenance senrice ar repairs be perfvrmed by the Gty,the property owner shall 6e charged For the costs af the maintenance andJ�
repairs,including necessary street repairs at a rate set annuaily I�y an administrative policy. It shali be the responsibi{ity of the applicarrt,
owner,occupant or user to perform standaeryd mai+ltenance of the sewer service line from the premises to the main including debris ciearing or
root�utting and to mair�tain the�ater service curb stap box for operahility and at such height as wilf ensure khat it remains above the finished
grade of the(and or property. (Ref 638,1158,i191)
. - +
�
' Request Number: 16613
Public Works Division
Service Request
Problem Address: 6912 Hickory Dr Requested By: Dennis George
Departraent: WATER Address: No address provic�d
Problemllssue: INSTALL AMR ME1ER Plrone Number: ?63-571-5789
Schedeled DAte: 2017-OS-1 `„' Schednled 1lme: Oi:00:00
/
AC'TION NEEDED:
Created by: Beth Kondrick Date Created: 2017-08-07
ACTTON TAKEN:
�IrLws�._�..���...�......._.._. ����� ___._.......
Status: Tn Progress Submitter Has Been r
Contacted
I?ate Completed: �` i � ` � � Completed by: � �
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