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11/1Y/2~e2 16:35
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HANSONS QUALITY PLUM
PAGE 02
CITY OF OSHKOSH WATER DISTRIBUTION
WATER METER PERMIT
(f1IIlUC PriIlt)
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Ma!tet(s) wtaiied At: d 7 -g L J-k,t.M ~ ~ ST
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Meter(s) Use: Checluhe U I) tm.tapply. .
Typical New ConstrUCtion . IJ .
Single Meter . ~
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Typical Multi-Unit, Multiple Meter ~
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Typical Deduct Meter .
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Typical Water Use Oni)' Meter _
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Note: 1. A Pluxnbing Permit may be required prior to the installation of the issued water
I!letel'(S ).
2. All plumbing must be conducted by 11 Wisconsin Licensed Plumber. except a. bome
owner may perform hislher own plumbing within their single family 1 owner occupied
home. For inquiries please call 236-5052.
3. Meters ~ 1-112" require a bypass.
Meter(s) will be instaUed and used according to the above information.
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Signature of Owner or Agent
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Print Name of Applicant and Cmn~ n"'/.l!'7b~.~
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