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CITY OF OSHKOSH WATER DISTRIBUTION
WATER METER PERMIT
(please Print)
Date: (,1'/1 "''11
Meter(s) Installed At: 2 tt 6 ~ /3;q k Ie eel er yo ~
Name of Owner: 5 r-CtAYI'.flr ~t'-5 -+,_c.
Address of Owner: t7J (J tV. W A:; 'I' 4~ c/ A..-" &7-.
Meter(s) Size: 'I'r:r "
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction
Single Meter
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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 home
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters ~ 1-112" require a bypass.
Meter(s) will be insUrlled and used according to the above information.
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Signature of Owner or Agent Print Name of Applicant
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