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METER(S) PERMIT
Date
/0/;0/91
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Name of OWner J; m J/ G.ba.sftt
Address of Owner
Meter Installed At 17'70
S. Do.. k. wood
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Meter(s) Size ~~
Meter(s) Use "Re.$jJ<:V\{:~1
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('Diagram of Use)
Meter will be installed and used according to the above information,
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;. Owner or Agent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
~~---~
Plumbing Inspector