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CITY OF OSHKOSH vi ÁTER DÍŠTRlBÚtlÖN
WATER METER PERMIT
Date: 1/ /L-7!DL
I I
Meter(s) Installed At: / q 7..:) l~ { LV- D LA- Y LA..
Name of Owner: t'1ll ( VC r:::- Ze-</ I (,;-,t::; l't~
Address of Owner:: . f q '7 ~ I-l ( C KDo.- Y .. t-- tA.
Meter(s) Size: I ,. .
Meter(s) Use: Check the Use(s) that apply.
Typkal ~;.~=- iv.. . TYP:"~~'PI. M= -
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(please Print)
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Typical Deduct Meter
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--
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Typical Water Use Only Meter
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Note: 1- A Plumbing Permit may be required prior to the installation of the issued water
meter(s). .
. 2. All plumbing must be conducted by a Wisconsin Licensed plumber, except a hQme
owner may perform his/her own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3- Met J 1-112" ~qUire a bypass. .
Metr(sr.'_/,~~#.#according to the above information., -
~- ~ (?~ ¿..---- 1) iZ H A III ~ ~ .J-
Signature of Owner or Agent Print Name of Applicant and Company