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METER(S) PERMIT
Date
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Name of Owner
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Address of Owner
Meter Installed At
Meter(s) Size
Meter (s) Use
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("Diagram of Use)
Meter will be installed and used according to the above information,
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OWner or A~ent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
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Plumbing Inspector
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