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METER (5) PERMIT
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Date ) /,~y 11/)
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Name of Owner
Address of Owner
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Meter Installed At l' .-5 {j - r\.-. P
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Meter (s) 5J.' ze '1 ''': d.A>" ...L}".
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Meter(s) Use
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Meter will be installed and used accord~ng to the above information,
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"'.-' bwne i' 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