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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55�43Z
(763)572-3566
�jWe hereby authorize the City of Fridley andjor its
employees to do what is necessary to repiace the water meter. I uncierstand that the property owner
is fiabfe for the water line from the main ta the premise and a1f interior p(umbing. (Per City code
4U2.06j 1 a(so hotd the City of Fridley and/its ernployees harmtess for any damages that may occur
while daing this operation. This to include,6ut not limited to;valves�piping,wallsl floars or the curb
� stap box and service 11ne. i understand I am aiso required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) � � ��
Name:
Address� � !� 'C�-�"�
Phane Num6er: Date: ����� .
Signature: �
_ Witness Signature: �
FRIDLEY CfTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
� ADMlNtSTRATION
{Ref Ord No 113,464,565,566,629,638,662,922,988,1144r 1156, 17.91)
402A5. PERM{T FEE
Prior to constructing or repair of any water or sewer line connectingthe existing municipai system and any house
or 6uildi�g for wh'tch the application 9s made,the owner or contractor sha(16e 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 natified. 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 C'rty as a
proper and suitab{e connection.
4�2.06. REPAIRS AND MAfNTENANCE Tl)CONNECTION
After the initiat connection has been made to the water service curb stop box or the sewe�lead at the property
iine or a water service or sewer lead has been extended to the property fine for connection,the appiicant,owner,
or the occupant or user of such premises shall be liable for all Kepairs required ta any water line and sewer lines
necessary for connection of the prernises from the main to the premises. lf the property owner requests
maintenance service or repairs be performed by the City,the praperty owner shall be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annually by an adminis�rative
poficy. ft shall be the respansibility of the appficant,owner,occupant ar user to perforrn standard mainte�►ance of
the sewes service line from the premises to the main including debris clearing o�root cutting and to maintain the
water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the fand or property. (Ref 638,1156,1191�