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CITY OF OSHKOSH WATER DISTRIBUtION
WATER METER PERMIT
(please Print)
. Date: 7- ~ ' if?
.Meter(s) Installed At: 3-530 OMAh' t/}/J.. .
Name of Owner: OIY1AlI CL/tsS + PAIAfT
Address of Owner: .SIW/&
Meter(s) Size: - J. /.
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction \/
Single Meter "'-
. Typical Multi-Unit, Multiple Meter
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.-- .-rD lSQLA....vALVII .
----11&I*I CDNI1UlL VALW
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~ 1MIrM't1aWlJl
............cama.VALft
Typical Deduct Meter ~
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Typical Water Use Only Meter.
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NO aANn'M't
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aANn'M'tawa
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""'----- Il6'ID cu.'aiI:IN VALva
a&DIG C3f1'..-x. 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 hgme
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.
I ~ -.....l:DmICI. VALVE .
Meter(s) will be ins~led and used according to the above information.
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Signature of Owner or Agent
. ~ V\. ~ .roL~ & 11'" S <;' ~. b. t\<. L-~~~S
Print Name of Applicant and Company