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CITY OF OSHKOSH WATER D1STRlBlJ'i'ION
WATER METER PERMIT
(please Print)
,Date: 11-/9-0 z.:
Meter(s} Installed At: Z Zas- #/..t7d?"eq ?Jr..
Name of Owner: !l""'" 3"~~~
Address of Owner: ~Z "BS'""'" ~/'C '
Meter(s) Size: "3'Aii ~ '25: " . '
Meter(s) Use: Check the Use(s) that apply.
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Typical New ConstruCtion
Single Meter K
. Typical Multi-Unit, Multiple Meter
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Typical Deduct Meter
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AI.J".OIWC ......AIn'" SI!MIt
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Typical Water Use Only Meter
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NO SAMrAIn'"
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A&.LDWED
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-.c.eca catma:IL VALVE .'
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~ MmJIt 1It:U,'oOf VALva
..-COIIfML VALVE
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 call 236-5052.
3. Meters 2: 1-112" require a bypass.
Meter(s~ll instldled and used according to the above information.
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Signature of Owner or Agent Print Name of Applicant and Company