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METER(S) PERMIT
Name of Owner /L;f;;A'A~t f?rl1Jii
Address of OWner /?ur' ~~tn~
Meter Installed At /,~/' A / j ~:"/ rL
Meter(s) Size ~ Ji fi' J"'-
Meteds) Use ~/.'d ~ : //
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(Diagram of Use)
Date
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Meter will be installed and used according to the above information,
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Owner or Agent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
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PIUmbi~gInspector
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