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METER(S) PERMIT
Date
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Name of Owner h4eey J);::_/ rf" l2.. .
Address of Owner ./ Ii 3 &(7 ~;:),./ ~-I
Meter Installed At r /~~~, ,~'7 76.- Cr'J/<c ~~?~ 6~ II.
Met:"r(s) Siz{';<-) 3/1 'I C bp/cA' )
Meter (s) Use 12?;5 /4J;; IV!); L.
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(Diagram of Use)
Meter will be installed and used according to the above
information, .
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'OWner or At'
To Water Utility: Requirements have been met to purchase
and install meter(s) at the above address for size and use
indicated.
Plumbing Inspector