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CITY OF OSHKOSH WATER DISTRIButION
WATER ME'TER PERMIT
(please Priat)
, Date: \'2..{2-q /2aJep
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Meter(s) Installed At: ~ D J --' " c' u.;.~ ~-. ,'~, l~
Name of Owner: 1IY'\ Q. r-c..u.. \"- y . 1 ~ f' l 11'\ \L
Address or Owner: ::'. . s:.o...~'-<L.
Meter(s) Size: . ~_ " , ~ V\ t:;' {;It
Meter(s) Use: Check the Use(s) that apply.
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Typical New Construction
Single Meter
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. Typical Multi-Unit, Multiple Meter
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---- -....a CQIIl1a. VALVI
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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: 1-112" require a bypass.
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Meter(s) will be insudled and used accorging to the above information.
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Print Name of Applicant and Comp'any
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