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METER(S) PERMIT
Date
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Name of Owner
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Address of Owner Rlo I t5~)( lJoNCSh/(,tJfLo ,Wi jV960
Meter Installed At i b s 7 /14...\1 /?Jie:; G U?'/\,'/ Of Ii' JG,(;IJ H
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Meter (s) Si ze -I'i
Meter (s) Use 11 FS,j'..! fJ" 11'-
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('Diagram of Use)
Meter will be installed
to the above information,
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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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G, . Plumb1ng Jnspectar