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10/15/2002 08:1':;~ 1-926-730-0898
HANSONS QUALITY PLUM
PAGE 06
CITY OF OSHKOSHW ATERDISTRIBUTION
WATER l\iETER PERlVllT
(PI- Prist)
Date: it --10- c7c
Meter(s)h1 stall ed.~~r (~b+ 1~.0
NameofOwner:.tJ':e ~ \J~~ - :
Juidn:g..~ Owni ,L:.: : - - ... ~ ::-,-
Meter(s) S!.Zri: 'S \I- -:- ,
Meter(s) Use: Check the Use(s} that apply.
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Typical New Co1lStt'l.lCtion
Single Meter
Typical Multi.Unit" Multiple Meter
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Typical. Deduct Meter A-
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Typical Water Use Only Meter
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Note: 1. A Plumbing Permit m.ay be required prior to the installation of the issued water
I'l'leter(s).
2. All plumbing must be conducted by a Wisconsin Licensed Plwnber, except a home
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please ca!1236.50S2.
3. Meters;:: 1-1/2" requ.ire a bypass.
Meter(s) ;-viti be in.stIdle~ and used according to the abo~ '. 'on. .~
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Si~ of Owner or Agent Print Name of Applicant and Company -
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