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CITY OF OSHKOSH WATER DISTRIBDtlON
WATER METER PERMIT
(please Print)
. Date: SJ{ yo-( .
Meter(s) Installed At: Z ~'3:.S;- H ~ c:.ko( Co.."..,..... J-
Name of Owner: D f. r c.c.,""'s~c..~u.", .
Address of Owner: zl..(t s:- J.-l~dU;hf Lo."'\.~
Meter(s) Size: y", ~~
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction
Single Meter
/
. Typical Multi-Unit, Multiple Meter
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----~c:cemax.VALWI
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Typical Deduct Meter
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A&.I.DWlI!Il ........,..--
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Typical Water Use Only Meter
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__CDJmIClL VALVE .
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on be instmled and used according to the above infonnationo
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Print Name of Applicant and Company
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