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METER(S) PERMIT
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Name of Owner CAlf,!
Address of Owner / l3 ()
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Meter (s) Size
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Meter Installed At
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Meter(s) Use
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('D~agram of Use)
Meter will be installed and used according to the above information,
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/ ~ter or Agent
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To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
. tAfl.lC/ (J~cl
Plumbing Inspector