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CITY OF OSHKOSH WATER DISTRIBUTION
WATER ME.TER PERMIT
(please Print)
" Date: I of /1id6
Meter(s) Installed At:SC) fJ 2- LeAke... \2..e"s-l- LY1 ~
Name of Owner: Uo.v;-J L rt- Joe',-"'\. PI. \Z ',--\-I"1(-\,If'\ \; c~ (r,o\.\d?'r?6(+<~"~)
Address of Owner:
Meter(s) Size: 3/ <f. 't
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction V
Single Meter --A.r--
. 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 hgme
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters~ 1-112" require a bypass.
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Meter(s) will be ins~led and used according to the above information.
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19nature of Owner or Agent Print Name of Applicant and Company