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METER(S) PERMIT
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Name of OWner(~/.'-~/7A"- ~) L~fp~
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Address of Owner )' ?.7(1 --;'t,c1:>1[<":v,:::--,, __6~O/1 fic/
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Meter Installed At '.o' L_"'.........\/'L.........-
Meter(s) Size ~-I
Meter(s) Use /..Cy~-.L.e<J>~;,
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('Diagram of Use)
Meter will be
installed and used according )0 the above information,
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OWner 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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L,_/ Plumbing Inspector