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METER(S) PERMIT
Date /p-~ 7- 9/
Name of OWner 0LA4AA~ {J.&/7<A~
Address of , OWner
Meter Installed At //8 y:J ~ ~
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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 Agent
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