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METER(S) PERMIT
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Name of Owner ~ -' . --Y;;#6<:-~
Address of Owner r/ JJ
Meter Installed At /13 ~ ~J"1 VA / .~r
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('Di agram of Use)
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 9ize and use ~ndicated.
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/7"'-, Plumbing Inspector