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- City of Fridley
Water Department
6431 Universiiy Avenue NE
Fridley,MN 55432
(763)572-3566
I Jwe hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. i understand that the property owner
is liable for the water line from the main to the premise and all interior piumbing. (Per Cjty code
402.06) i aiso hold the City of Fridley and(its employees 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
� stap box and service line. I understand I am aiso required ta obtain a permit prio�to any work,if
necessary.
Final meter readin old meter ` �� y O
et )
���� l`J�1�
Name: Address: —
Phone er: Date: � `� � '�
Signature• L `
Witness Signature:
FRIDLEY CiTY CODE
CHAPTER 402.WA7ER,STORM WATER,AND SANfTARY SEWER
ADMINISTRATION
�Ref Ord Na 113,464,565,566,629,638,662,922,988, 1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or 6uilding for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shell pay a permit fee as provided in Chapter 11 of this Code. After such cannection has been
made,the Water and Sewer Department shali 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. REPAtRS AND MAINTENANCE 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 to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be fiable for all repairs required to any water line and sewer lines
necessary for connection of the premises fcom the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the�esponsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main inciuding debris clearing or root cutting and to maintain Che
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)