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HomeMy WebLinkAboutWater Meter Permit CITY OF OSHKOSH WATER DISTRIBUTION WATER METER PERMIT (please Print) . Date: /.- 2 5.- Q 7 Meter(s) lustaUed At: 1ft ~B c.) Tier . . . . :ffi; Name or Owner: I ~. "- &u(Y\-<..v- r jlc. r l\ Y ,<oW /:lea \ - ) Address of Owner: _2 _ i-J iter U-- ..., " Meter(s) Size: <.. J Meter(s) Use: Check the Use(s) that apply. . Typical New Construction V Single Meter ~ . Typical Multi-Unit, Multiple Meter ..... ..-A1IDIIVALVII . "i .... I .,..TD .,..-......., II!WD _J' ..... .-nR1ICLA1IDIIVAoLVD . ---- ~CClNI'KOLVALft ~ ". ~fJlI~_1'O ~ UMfMrIaWlll ~__c:ama.VALVI -- Typical Deduct Meter NO UlllfMlf ..JUIIllCl..... o.r: v_m A&,LOWI!I) .......,- - L ..,., .- Typical Water Use 9nly Meter IIII'lIR IIClLA....VAUIII +~ NO aAMrM\' -01ICM_ AU.OWID ""'CIo"..... m aAMr.,UWD -. /'. ~ 1IRD1IU,Alil:llllVALVU __ CDfI"oIQ. VALVI Note:' 1. A Plwnbing Permit may be required prior to the installation of the issued water meter(s). . 2. All plwnbing must be conducted by a Wisconsin Licensed Plwnber, except a hQme owner may perform hislher own plwnbing within their single family, owner occupied home. For inquiries please call 236-5052. 3. Meters 2: 1-1/2" require a bypass. I ~__CDmICILVALVE . Met"e~~ used according to the above infOrmation. '. . . ()~ ShctW^~e7rV\ q Sigmture of ~or Agent !1. I Print Naine of Applicant and Company ?ii ttr II/lffd f (J Le?f7. . eLO)~Yb-5L1/3' (6-JI\.~ ~~)