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City of Fridley
Water Department
6431 University Avenue NE
f�idley,MN 55432
(T63)5?2-3566
IJwe hereby authorize the City af Fridtey andjor i#s
employees to do what is necessary to reptace the water meter. t understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City cade
402.d6) t atso hold the C'ity of Fridley and/its employees harmless far any damages that may occur
while doing this aperation. This to inctude,but not iimited to;vaives,piping,wa{Is,floors or the curb
stop box and service line. 1 understand I am also required to obtain a permit prior to any wark,if
necessary. ��� �
pinal meter readina(�1�meter) �
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Name• Address• � -+"�
Phone Number• Date• 6�'�` '�
Signature• <� �� � �
Witness Signature:
FRIDLEY CiTY C�DE
CHAPTER 402.WATER,STORM WATER,AND SANfTARY SEWER
ADMIN{STRATION
(Ref Ord No 113,46�4,565,566,629,638,662,922,988, 1144,1156,1191)
402.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipai system and any house
�r buifding for which the.application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shaU pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shaN be notified. It shal{be unlawful to cover any connecting fine 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.
4U2.06.REPAIRS AN�MAiNTENANCE TO CONNEC7'iON
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{ead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shaH be liable for afl repairs required to any water tine and sewer lir►es
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 owner shail be charged for the costs of the
maintenance andlor repairs, including any necessary street repairs,at a rate set annualty by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance af
• the sewer service line fram the premises to the main including debris ciearing tir root cutting and to maintain the
water service curb stop box for operability and at such height as wilf ensure that it remains above the finished
grade of the land or property. {Ref 638,1156,1191j