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METER(S) PERMIT
Date
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Name of OWner
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Address of Owner
Meter Installed At
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Meter (s) Size
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Meter (s) Use
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('Diagram of Use)
Meter will be installed and used according to.the above information,
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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U pI Umbing Inspector
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