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METER(S) PERMIT
Date
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Name of Owner C if, '1,( O~ I~ /
Address of Owner .
Meter(s) Size
Meter Installed A.t It76 s-;~' //j~~r~
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Meter(s) Use
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(Diagram of Use)
Meter will be installed and used according to the above
information, .
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OWner or Agent
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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.