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City ot Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-356fi
1/we hereby authorize the City of Fridley and/or its
empfoyees to do what is necessary to reptace the water meter. 1 understand that the property owner
is liable for the water line fram the main to the premise and ail interior plumbing. (Per City code
402.06) t also hold the City of Fridley and/its emplayees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb
� stop box and service line. I understand I am also required to obtain a permit prior ta any work,if
necessary.
final meter reading(old meter� �� ` ���
Name� Address• 1V�L/ � � —
Phone Nu Date: ���-..�_-- •
Signatur :
. Witness Signature: .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMIINISTRATION
(Ref Ord No 113,464,565,566,629, 638, 662,922,98Sr 1144r 1156,1191)
402.05. PERMIT FEE
Prior to constru�ting or repair of any water or sewer line connecting the existing municipal system and any hotl�
or building for which the application is made,the owner or contractor shall 6e required to obtain a permit for such F�
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 Qepartment sh�ll 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 MAIN7ENANCE TO CONNECTION
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 lead has been extended ta the property line for connection,the applicant,owner,
or the occupant 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. tf the praperty owner requests
maintenance service or repairs be performed by the City,the property owner shall he charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a raCe set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar user to pe�form 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)