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METER (S) PERMIT
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Name of OWner0-"5"'/c
Address of Owner /.:5";5-/
Meter Installed At /~~lj'o ,
Meter(s) Size :3~~
Meter (s) Use
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("Diaqram of Use)
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Meter will be installed and used according to the above information,
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f,/ / oWner or J{gent
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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.
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I Plumbing Inspector