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. CITY OF OSHKOSH W AnR DISTRIBUTION
WATER ME.TER PERMIT
(please Priat)
. Date: /kA4';
.
"Meter(s)IDstalledAt f'~~ ~~~~tJ/t '.. tuwl .~
. Name of Owner. ~~#'.S.I /J~4~~ I ~'" (.
Address o~Own~ " '(f,; 'N ~.I,..t''(hf.'~'"'' 1J(!. ~r'/Ih.;I.... :~B.r ..IU~ /1 .
Meter(s) SIZe: . ~ti _ ___ . --
Meter(s) Use: Cb"eek the Use(s) that apply.
Typical New ConstrUCtion
Single Meter
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. Typical Multi-U~ Multiple Meter
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i- ....ISDI.A....YA&.WD .
----...."aIImICIL YALW
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Typical Deduct Meter
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M&.l:IWIID
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Typical Wateir Use Only Meter
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Note:' 1. A Plwnbing Permit may be required prior to the installation of the. issued water
m~e~~. .
. 2. All plumbing must be conducted. by a Wisconsin Licensed Plumber, except a h~e
owner may petform hislher own plwnbing within their single family. owner occupied
home. For inquiries please call 236-5052.
3. Meters ~ 1-1/2" require a bypass.
Meter(s) wi! be instlrlJe:d and used according to the above infonnation.
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Print Name of Applicant ~d Company.