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CITY OF OSHKOSH WATER DISTRIBUTION
WATER METER PERMIT
(please Print)
Date: ICJ.. 23 - 00
Meter(s) Installed At: 2 3 58 H'Clt:.o #'V'7 LA,J,;:
Name of Owner: KG J I ,J .4 ,J () LA t; Co
Address of Owner: 2. 35""8 1-" ~'GcA--1' lrA,.)t:t'
Meter(s) Size: 3/'1 ",
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction
Single Meter
y
Typical Multi-Unit, 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 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 home
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.
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Meter(s)will be insUrlled and used according to the above infoImation.
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Signature of Owner or Agent
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Print Name of Applicant and Company