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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
empioyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabie for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) (also hoid the City 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,walls,floors or the curb
stop bax and service line. 1 understand 1 am also required to obtain a permit prior to any work,if
necessary. �
ter readin otd meter) � � � `�'��
Fina�me 8(
Name• Address� J� ����
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Phone Number: Date:
Signature• "`�'" �
1Mtness Signature:
FRIDLEY CITY CODE
GHAPTER 402.WATER,STORM WATER,ANO SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156, 1191j
402.05. PERMlT FEE
Prior ta 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 shatl 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 untii an
inspecfiion 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.REPQIRS AND MAlNTENANCE 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 be liable for ati repairs required to any water line and sewer lines
netessary 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,t�e property owner shall be charged for the costs of the
maintenance and/or repairs, inctuding any necessary street repairs,at a rate set annually by an administrative
policy. It shal!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 bax for operabitity and at such height as wiil ensure that it remains above the flnished
grade of the land or property. (Ref 638,1156,1191�
Request Number: 11915
Public Works Division
Service Request
Problem Address: 6030 Stinson Blvd Requested By: Sandi Hara
Department: WATER Address: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: Scheduled Time:
ACTION NEEDED:Final reading.Clos' g 8/30/16 T#34277737
Created by: Wendy Hiatt Date Created: 2016-08-25
ACTION TAI�N:
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Status: In Progress Submitter Has Been � �
Contacted
Date Completed: Completed by:
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