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METER(S) PERMIT
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Name of OWnerc::>r~ ~ .r
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Meter Installed At / i d 5' ((!)~
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Address of Owner
Meter(s) Size
Meter (s) Use
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("Dia<;;rram 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.
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) Plumbing Inspector