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CITY OF OSHKOSH W ATERDISTRIBITTION
WATER METER PERMIT
(please Print)
Date: if'::-I "'''''''03
Meter(s) Installed At: .L( J.J \.1 ~tY"'v
Name of Owner: 4-4--~ ) ril-1' P"a--/.1'VII'. ,Wv.- -. k-N! FJ
Address of Owner: _ ..y Nit" 4-"......, ~r
Meter(s) Size: . "3/1 . . .
Meter(s) Use: Check the Use(s) that apply.
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Single Meter ~
. 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 issue~ 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: 1-112" require a bypass.
Meter(s) will be insurtfed 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
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