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METER(S) PERMIT
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Name of OWner
Address of Owner
Meter Installed At
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Me te r ( s ) Size .: ! 'I
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Meter (s) Use
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Meter will be installed and used according to the above information,
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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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"Plumbi~-~ Inspector