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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
emptoyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) 1 alsa hold the City of Fridley and/its empioyees harmless for any damages tfiat may ouur
while doing this operation. This to i�clude,but not fimited to;valves,piping,walls,floors or the curb
� stop box and service iine. i understand 1 am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) ��(,e,����
Name• Address• c �� � U �,�� ��
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Phone Number. Date: ,
5ignature•
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SAPIITARY SEWER
ADMINISTRATION
(Ref Ord No 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 eonnecting the existing municipal system and any house
or 6uilding fo�which the application is made,the owner or contractor shalf be required to obtain a permit for such
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 Department shafl be notified. It sha11 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 MAtNTENANCE 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 ar sewer lead has been extended to the prvperty line for connection,the appficant,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 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
polity. It shall be the responsibility of the applicant,owner,occupant or user to perf'orm standard maintenance of
the sewer service line from the premises to the main including debcis clearing or root cutting and to maintain the
water service curb stop box for operabitity and at such height as will ensure that it remains above the finished
g�ade of the land or property. (Ref 638,1156,1191}
Request Number: 10528
Pubfic Works Division
Service Request
Problem Address: 5801 University Ave Requested By: Sandi Hara
Department: WATER A�ddress: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: Scheduled Time:
ACTION NEEDED:Final reading.Closi 9/25/1 ERT#33303128
Created by: Wendy Hiatt Date Created: 2015-09-Y4
ACTION TAI�N:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
�W,/� �/ . . .