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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
employees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line fram the main to the premise and all interior plumbing. (Per City code
402.06) f also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,6ut not limited to;valves,piping►walls,floors or the curb
stap bux and service Ilne. I understand I am also required to obtain a permit prior to any work,if
necessary. ��� ���
Final meter reading(old meter)
Name� �
Addr�ss: �L� ��
• � '
Phone Number: 6�� �7 l� y��Date: ��� � —
Signature: '1�� .
. Witness Signature: � �
FRIDLEY CfTY CODE
CHAPTER 402.WATER,STQRM WATER�AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638, 662,922,488,1144,1156,1191�
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anjr house
or building for which the application is made,the owner or contractor shall 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 connectian has been
made,the Water and Sewer Department shall 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.
4U2.06, REPAIRS AND MAIN�'ENANCE 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 ae liable for all�epairs required to any water line and sewer lines
necessary for connection af the prernises from the main to the premises, tf the property owner requests
maintenance service or repairs be performed by the City,the property owner shal�6e charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. It shall be the responsibility of the appticant,owner,occupant ar user to perform standard maintenance of
the sewer service line from the premises to the main including debri5 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
g�ade of the land or property. (Ref 638,1156,1191j