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. City of Fridley
Water Department
6431 UniversityAvenue NE
Fridley, MN 55432
(763j 572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. I understand that the properly owner
is liable for the water line fram the main ta the premise and all interior plumbing. (Per City code
40Z.06y t a(sn hold the City of Fridley andjits employees harmless for any damages that may occur
while doing this operation. This to include,but nat 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 to any work,if
necessary.
Final meter reading(old meter) �� `!� ����
Name: Address:
l,a��- ����
Phone Number: Date: ��' �"�� •
� 5ignature: ���'1✓Uv-'"��`��� �
. Witness Signature: . .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANtTARY SEWER
AD1V'IINISTRATION
(Ref Ord No 113,464,565,566,629, 638,662,922,958,1144,1156,1191)
402,U5. PERMITFEE
Prior to constructing or repair of any water or sewer Nne connecting the existing municipal system and anq hause
or 6uilding for which the application is made,the owner or contractor shall be required�o obtain a permitfar such
w��Fl2c�I0T1�an�shall�a�TaTermit fPP a��,rovided in Chapter 11 of this Code�. After such arnnection has been �
made,the Water and Sewer�epartment shall be notified. It shafl be unlawful to cover any conne ing�n ���
inspection has been made and such conneetion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTICIN
After the initiat 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 6e 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 he charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
palicy. It shall be the responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the sewer service line from the premises to the main including debris clearing or root wtting and to maintain the
water serv)ce curb stop box for operability and at such height as will ensure that it remains above the finished
grade ofthe land or property. (Ref 638,i156,1191}