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CITY OF OSHKOSH WATER DISTRIBUTION
WATER ME.TER PERMIT
. Date: Sf 'f(o"?
II d A Co t tv G -p-- Av.e
Meter(s) Insta e t~, r
Name of Owner: S"'..o'"'V~~":> ,AfC.('Y:~":1(5
Address of Owner: ct ~C) F.ct~.t f.€vr1qJ Av~
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Meter(s) Size: ~(~
Meter(s) Use: Check the Use(s) that apply.
(please Print)
Typical New Construction
Single Meter
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. 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 hQme
owner may pe,rform hislher own plumbing within their single family, owner occupied
home. For inquiries please ca11236-5052.
3. Meters 2: 1-1/2" require a bypass.
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M~ter(s), will be ins~lef and used according to the abOVerinfO~.ation. ,
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i Signature of Owner or Agent Print Name of Applicant and CompaIJ.y.
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