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METER(S) PERMIT
Date
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Meter Installed At
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Name of OWner
Address of OWner
;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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. ,~ 'wner or Agent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for si ze and use indicated.
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