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CITY OF OSHKOSH WATER DISTRIBOtlON
WATER ME'TER PERMIT
(please Print)
. Date:
91?Jijol
'Meter(s) Installed At: ;'1-03;;' tJ-tWrv:r+ ~
Name of Owner: C \f'\tC L k.. \-6.1..e~. '
, Address of Owner: . . ~~~ -:L t.-),~tAJ(>ill--J
Meter(s) Size: 31 '-i
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction
Single Meter
. Typical Multi-Unit, Multiple Meter
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Typical Water Use Only Meter
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Mete~ wi.ll be instlrlled and used according to the abo~e info,nnation. . .
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Signature of Owner or Agent Print Name of Applicant and Company