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CITY OF OSHKOSH WATER DISTRIBUtION
WATER METER PERMIT
(please Print)
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Meter(s) Installed At: ~ 6 0 !.-Il. A- c. S '-rf2-.tJ"GT
Name of Owner: .b CF tv g-y /+01-1 t:?:5
Address of Owner: I. e:; LI I 13 G EK:. /-.J :;. J; .J CJ ~ H j(p j 1-/, Lv- I S '-I Cf'e; I
Meter(s) Size:. )/'d/I
Meter(s) Use: Check the Use(s) that apply.
Typical New ConstruCtion
Single Meter
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. Typical Multi-Unit, Multiple Meter
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Typical Deduct Meter
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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. Meters 2: 1-1/2" require a bypass.
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Meter(s) will be insurlled and used according to the above information.
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Signature of Owner or Agent
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Print Name of Applicant and Company