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CITY OF OSHKOSH W ATERDlSTRIBOtlON
WATER METER PERMIT
(please Print)
,Date: 8,-~L/~(J7
'Meter(s) Installed At: \).505,: kC)e/I~.fi((d,CDdr ka.-sJ. j u a::-
Nameo(Owner: 'F=";/)/!lt. ~~~." '
Address ofOwner:-S~O ,5.' eo' t='.'" Jfk(. .
Meter(s) Size: r~ c, ' .
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction /
Single Meter V
. 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 hgme
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please ca11236-5052.
3. Meters 2: 1-112" require a bypass.
I ~-.a.ca~VALVE.
Meter(s) will be instnled and used according to the above information.
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Signature of Owner or Agent
C)C\~.
Pri" t Name ofApplic t and Company