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Name of Owner
Address of Owner
METER(S) PERMIT
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Meter Installed At
Meter(s) Size
Meter(s) Use
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(Diagram of Use)
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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