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Ma~ 14 O? 01:43p
920230365?
p.2
CITY OF OSHKOSH WATER JjiSTRffitri']'ON
WATER METER PERMIT
(please Print)
. ..s' - JM -0""
. Date: I 1
L .. -;;.f.
.Meter(s) Installed At: L I j "7 MC!)~T V er Not'\.
Name of Owner: Dewey' f..I(TJ.~~ -:.:z"G.
Address of Owner:=- .~ 76& ;>CJot.v.~f..lo,) c-l.
Meter(s) Size: ~/~..
Meter(s) Use: Check the Use(s) that ~pply.
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Typical New ConstrUction \/'
Single Meter --f::--
. Typical Multi-U~t, 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 Plwnbing Pennit may be required prior to the instill1ation of the issued water
meter(s).
. 2. All plumbing must be conducted by a Wisconsin Licensed Plumber, except a hQme
owner may perform hisfher own plumbing within their single family, owner occupied
home. For inquiries please ca11236-S052.
3. Meters?; 1-11211 require a bypass.
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Meter(s) will be insudled and used according to the above information.
L.-JoA.. S ptec..~er' .s as I JI.A.~~.... LLC.
Print Name of Applicant and Company
Signature of Owner or Agent