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CITY OF OSHKOSH WATER DlSTRIBUtIoN
WATER METER PERMIT
(please Print)
. Date:/~;:6'G
Meter(s) Installed At: !-{?/(rJ19/zr7J ct /4/5' /
Name of Owner: jJ/J/ / ~ ~ I'~.t:{ Ui/'I"7'le:
Address of Owner: /9",~ /. ~~(~~7 rem c..-r
Meter(s) Size: :3,{V~- (
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction .. '\/1 .
Single Meter ~
. Typical Multi-Unit, Multiple Meter
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Typical Deduct Meter
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Typical Water Use Only Meter
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Note:. 1. A Plumbing Permit may be required prior to the installation of the issued water .
meter(s).
. 2. All plumbing must be conducted by a Wisconsin Licensed Plumber, except a hQme
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please caII 236-5052.
3. Me!;rs2: 1-1/2" require a bypass.
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Meter(sJ..\vi:ll be instslIed and/uS"e ccording to the above information.
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.//'%~ fi-. ..-<:::.. 11"2(/740'/ . /v1,( lJ~e~
t// ._,,$i~ature of o~ Print Name of Applicant and Company
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