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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 Fridiey and/or its
employees ta do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line from the main ta the premise and all interior plumbing. (Per City code
4�2.06j 1 also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,fioors or the curb
stap 6ox and service line. 1 understand I am also required to abtain a permit prior to any work,if
necessary.
Final meter reading(old meter) , �
Name: Address• ��� �` �-'"�4�
Phone Num6er• Date: ��'� — �
Signature: �
. Witness Signature: ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANiTARY SEWER
� ADMIINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156, 1191)
40Z.05. PERMtT FEE �
Prior tv constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the application is made,the owner or contractor shall 6e 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 shall be notified. It shall be unlawful to cover any connecting line until an
inspection has heen made and such conne�tion and the work incident thereto has been approved by the Crty as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCETO CONNECTION
ARer the initial connecCion has been made to the water service curb stop box or the sewe�lead at the prope�ty
line or a water service or sewer lead has been extended to the property t�ne for connection,the applicant,ownet,
or the accupant or user of such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property awner shall be charged for the costs of the
maintenance and/or repairs, iacluding any aecessary st�eet repairs,at a rate set annually by an administrative
policy. 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 stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156, 1191)