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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
IJwe hereby authorize the City af Fridley andJor 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 ali interior piumbing. (Per City code
402.06) i also hold the City of Fridley and/its employees harmless for any damages that may o�cur
while daing this operation. This to include,but nat limited to;valves,piping,wafts,ftoors or the curb
� stap box and service line. I understand I am also requlred to obtain a permit prio�t�any work,if
necessary.
Final meter reading(old meter) O
Name: Address:
{ 5— c� ���'� '
� Phone Number: Date: �—��� �� •
Signature:
_ Witness 5ignature: .
FRIDLEY CITY COdE
CHAf�TER 402.WATER,STORM WATER,AND SANITARY SEWER
ADNIINISTRATtON
(Ref Ord No 113,464,565,566,6�9,638,662,922,988.1144,1156, 1191)
40Z.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or buiiding for which the application is made,the owne�or contractor shalt 6e 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 shall be notified. lt shall be unlawful to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the Gty as a
praper and suitable connection.
402.06. REPAIRS AND MA►INTENANCE TO CaNNECTION
After the initial connection has been made to the water service curb stop box or the sewe�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 accupant or user of such premises shall be liable for all�epairs required to any water line and sewer lines
necessary for connection af the premises from the main to the premises. If the property owner requests
maintenance senrice 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 responsibility of the applicant,owne�,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris c{earing or root cutting and to maintain the
water service curb stop box#or operability and at such height as will ensure that it remains above the finished
g�ade of the land or property. �Ref 638,1156,1191J