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FRIDLEY
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Old Meter Number ��
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Replacement No. ����"�����
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Replacement ERT#
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City of Fridley
Water Department
6431 University Avenue NE
Fridfey,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to repiace the water meter. I understand that the property owner
is liable for the water line from the main to the premise and ali interior plumbing. (Per City code
402.06) i aisn hold the�ty 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,walis,floors or the curb
� stop box and service line. t understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) `���� � �
Name• Address� �LJ�, � ��"�7
Phone Number: Date: �`(/` "���
Signature� � �
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191)
402.05. PERMlT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shalf be requi�ed to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connectian has been
made,the Water and Sewer Department shali be notified. It shall be unlawfui to cover any connecting line until an
inspection has been made and such connection and the wark incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS 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 shali 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 owner shall be charged for the casts of the
maintenance and/or repairs, including any necessary 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�
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Request Number: 6316
Pubiic Works Division
Service Request
Problem Address: 6350 7th St Requested By: Kent Chrissy
Department: WATER Address: No address provided
Problem/Issue: TURN WATER OWOFF(WATER) Phone Number: 612-462-0180
Scheduled Date: 2013-07-02 Scheduled Time: 08:00:00
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ACTION NEEDED: turn off water for repair permit#2013-01277
Created by: Wendy Hiatt Date Created: 2013-06-27
ACTION TAKEN:
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Status: In Progress Resident Contacted O
Date Completed: Completed by:
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MINNESOTA PIPE & EQUIPMENT
5145-211th Street W�st•P.O. Box 249 2913•County Road 16 SW
Farmington, MN 55024 Rochester, MN 55902
Phone(651)463-6090 Phone(507)285-5389
Toll Free(800)325- Toll Free(877)207-6191
Fax(651)46 4 Fax(507)285-5392
minn otapipe.com
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Request Number: 12415
Public works Division
Service Request
Problem Address: 6350 7th St Requested By:
Department: WA'IER Address: No address p�ovided
Problem/Issue: WATER SERVICE LEAK Phone Number:
Sc6eduled Dste: 2016-12-09 Scheduled 1Ime: 02:00:00
ACIION NEEDED:Water main lxeak
Created by: We�y Hiatt Dite Created: 2016-12-12
ACIION TAI�N:
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Status: In Progress Snbmitter Has Been r
Coutacted
Date Completed: Completed by:
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