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CITY OF OSHKOSH WATER DISTRIBUtION
WATER METER PERMIT
(please Print)
. Date:$- X.- 0 4,?
'Meter(s)Installed~ '., ~Dl'~ ~(;~'rls Cli,~ h "'5A~sl"1 ~f)lel.Yt..rF:-w~~
Name of Owner: ="\~ ~\ l~k~/u:.'1
Address of Owner: 1P (c ,: G....e.eA'.~ lJe b!'~ (; -ret?JIl 11-.' 111' I.JI
Meter(s) Size: 'l'r . .
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction X'
Single Meter _
. Typical Multi-Unit, Multiple Meter
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..... .-rD1IOLA1IDIIVALVD .
------..... CClN'1'RCL VALVI
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Typical Deduct Meter
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..,. a.elll'_ r'"""'" 11'_'10
MLOWI!D .......AIW....,.
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Typical Water Use Only Meter
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NO SAMrA1ft'
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~ .-r!It1lt.:U.\o.VA&.VD
__ CDn".-aL VA&.VII
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 ~ 1-1/211 require a bypass.
I ~__CClImlCILVALW .
'11 be insqIled and used according to the above information.
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:J ~,,4.'- $' , iAo' Wi b l
Print Name of Applican and Company