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HANSONS QUALITY PLUM
PAGE 01/132
CITY OF OSHKOSH WATER DISTRIBUTION
WATER l\1ETER.PERMIT
(Pie&$l! Priat)
Date: Ii hB laL
Meter(s) Installed Ac_ .d751 4~J I~'h S,- . .
Name or Owner.. CChJ - (! ~A7'HJ 6 ~' &:.1ST^"""
Address of Owaer: 10;"1 (..'~p ~~ G,~e./:'1 di
Meter(s) Sizl::_~ ~ "J/v
Mder(s) Use: Check the Use(s) tbat apply.
Typical New ConstrUction . X
Single Meter .
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Typical Deduct Meter
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Typical Multi-Unit, Multiple Meter
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TyPical Water Use Only Meter
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Note: 1. A Plumbing Permit may be required prior to the installation of the issued water
meter(s).
2. All plumbing must be conducted by a Wisconsin Licensed Plumber, except a home .
owner may perform histher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters ~ 1-1/2" require a bypass.
M~ ..\'ill be mst4lHed and used according to the above infommtion.
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Signature of Owner or Agent Print Name of Applicant arid. Com
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