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HomeMy WebLinkAboutWater meter permit ~/!1~/~~~2 13:~/ 1-~~~-13~-~~~~ HANSUNS l~UALl t '( PLUM t-'AGil:. ljl;j CITY OF OSHKOSH WATER DISTRIBUTION WATER METER PERMIT (PI- Primt) Date:...:2:::[? -ot.. ._ M<ter(s) hmalled At: ~7 ~ d"", /k>,~_ NameofOwuer..Dt~ ~-<:!h~ " Ad_ofo..aor:~~ ~t .M:eter(s) She: : . Muer(s) Us.: Check the U e(s) that apply. rSv~O/ ~ = Typical New C011Sl1'UCtion i/ Single Meter 4..--.- Typical Multi-Unit. Multiple Meter 18Il'!IIJt~.... ~ ...... lIIIIII-=J'~ .....-~- / . .... ........ _rIlUIlII&A1...".. -----..~~~ ~_l!1"1'l:I ..,....,.,., ~- '41/1""---'''''' Typical Deduct Meter -~ 1IllWllIliI ~1liI8lI ~ Typical Water Use Only Meter -=1.flII\IJa1Q ~- 1III!lI!R...._........ ~~. 1 :::: = I "~ClI'IImICIL,,.._ . -~ _l:'li1II:llllRflla ~ ll@M.. v",1'U lI'AlllWM't'~ /' ~ IfItOIJlUlII:lI",,_WiUIlI1l -W.IU:I;l__WlI.l4 Note: I. A PlUIribing Permit may be required prior to the instailationof the issued water meter(s). 2. AU plumbing must be conducted by a Wisconsin Licensed Plumber, except a home. owner may perform his1her own plumbing within their single family, own~ occupied home. For inquiries please call236-S052. 3. . Meters ~ 1-1/2" require a bypass. Metet(s) will be instlifled and used according to the above infonna.tion. ;:P~d~ . Signature of Owner or Agent \ /l2P-e. iG C - P'~d/>c!-'"1"_ d.n>.I"""~ (Jl.C/;"!' 7j Print Nam.e of App.u~t and Company 1'l~bC::s ~ .. ...:..:--....