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CITY OF OSHKOSH WATER DISTRIButION
WATER METER PERMIT
(please Print)
tj/17/0b
. Date: Y ,
. Meter( s) Installed At: G L{ ( i.~~ +1-\. l~ U .(!. tr't u<'
Name of Owner: .lLv~'<e.".. Co ",-~'h""oJI.. c..t-^.".:l ""
Address of Owner: ,3 2..0 l Co..;... "'- Rd 1=
Meter(s) Size: .."2 t.{
Meter(s) Use: Check the Use(s) that apply.
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Typical New Construction. /
Single Meter --1L..
. Typical Multi-U~ Multiple Meter
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---- -.DIG Cl:ItITRClL VALVI
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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 calI 236-5052.
3. Meters~ 1-1/2" require a bypass.
Me~,:,~?}-wH} ~e ins~led an~ used according to the above inf~rm~ti~n. I
/. I --:::../6 C('-~~- ~.J- rf c f ON e. t{ C) . \ IV ~. vi tV' + ..
V Signature of Owner or Agent Print Name of Applicant and Company ~
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