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CITY OF OSHKOSH WATER DISTRIBOtlON
WATER METER PERMIT
(please Print)
. Date: '/23/~'7
Meter(s) Installed At: 3<g<?O J;J,e<.UreJ. RocJ. .. .
Name of Owner: Lcr.~~l. Ha.Me-S . (~'Ic:"...J;j I NOtAcy $ Co..<;.ey \
Address of Owner: .'903 ''17.../IfJJ'' 12coJ Ntblc...~, wX- !;'Ict5t
Meter(s) Size: '3/<1(lt
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction V
Single Meter ~
. Typical Multi-Unit, Multiple Meter
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......- -........asau.....VALVD .
----II&I*CI CCINIRClL vA!.W
~C".. 11'_1'0
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Typical Deduct Meter
NO Ulftlll't
'8WD~ C......, 11'_1'0
AIJ,OWI!I). ....,........
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Typical Water Use Only Meter
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NO UMrIlf't
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"""---- IIID'IJt IIU.A\o. VALva
~=-~VALW
Note: . 1. A Plumbing Permit may be required prior to the installation of the issued water
meter(s).
. 2. All plumbing must be conducted by a Wisconsin Licensed Plumber, except a hQme
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters 2: 1-1/2" require a bypass.
I ~......cmmICIL VALVE .
Meter(s) will be insurlled and used according to the above information.
La.,j ~ Sl'e-~\~ . .s Bs 1\.1."'-
Print Name of Applicant and Compan