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METER(S} PERMIT
Date
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Name of Owner cnlS~~T. V" ntl$C-fl
Address of Own:l/57'<~'-- U't!J.k.. j.Vt:74J.d
Meter Installed t .;s1'9#~>1e- 1'1
Meter(s) Size
Meter(s} Use
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('Diagram of Use)
Meter will be installed and useJl;r:cor~i;g ~~~ove
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OWner or Agent
information,
To Wa.ter Utility: Requirements have j:)een met to purchase and
install meter(s} at the above address for size and use indicated.
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