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CITY OF OSHKOSH WATER DISTRIButION
WATER METER PERMIT
(please Print)
. Date: If l 2'-/ lQk
: Meter(s) Installed At: Z 3.. I " .:r ~ F F G1L ~ c /-t
Name of Owner: ..s /+e-. U-r c:!AS, (J C '(..( J. y- ~J-"t. 140M <J'S
Address of Owner: 2 r-;.S"~ /..\ L ~ M 1\. r1 (" V/')l \ tP ~ /.". rt;JII:5, 1+..
Meter(s) Size: ~/'7 I' . ..If
Meter(s) Use: Check the Use(s) that apply.
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TYPicalsJo:lew1 CMonstruction /
mg e eter
. 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 hQme
owner may perform his/her own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters 2: 1-1/2" require a bypass. .
Meter(s) will be insurIled and used according to the above information.
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Signature of Owner or Agent
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Print Name of Applicant and Company