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CITY OF OSHKOSH WATER DISTRIBUTION
WATER METER PERMIT
(please Print)
Date: /(!J-I::< -98
~t~ .
Meter(s)Installed~t: ~ql"'eO GAS"L/6I-1r Cr:' ()SH~-t{
NameofOwner:_LEc:::>-A c...-r' ~~.\\. :D~'S
Address of Owner: pt') ~ /27 n S H /L() S" i-J ,C:::;-4 9() :3
Meter(s) Size: '3/4~'
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction /
Single Meter \;
Typical Multi-Unit, Multiple Meter
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~IUILDINGCClNTRQL VALVE
......~CCNIRDL VALYIE
Typical Deduct Meter
Typical Water Use Only Meter
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ALLOWED
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OSICWIIGE TO
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Note: 1; A Plumbing Permit may be required prior to the installation of the issu~d water
meter(s).
2. All plumbing must be conducted by a Wisconsin Licensed Plumber, except a home
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters ~ 1-1/2" require a bypass.
~talled and used acco ding to the above information.
~ ' - c is PCJ/Yl.(3,.-.JG-
Signature of Owner or Agent