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METER(S) PERMIT
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Name of Owner
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Address of Owner i,; f Ie 0 C_,lh' ~. T (YI (') r,ff/!'; k? 0
Meter Installed At .I Jr"!""! rJ. C) .41 Ie (,;/ /I:J -:> 1-:)
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Meter (s) 5i ze
Meter (s) Use
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('Piagram of Use)
Meter will be installed and used according to the above information,
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OWne r or Agent
To Water Utility: Requirements have been met to purcha$e and
install meter (s) at the above adCl.ress for size and 'l.ts/indicated.
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