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METER(S) PERMIT
Date
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Name of Owner
Address of OWI]er J' A "
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Meter Installed At ,l??o A'~....A:~~~
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Meter (s) Size
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Meter(s) Use
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Meter will be installed and used according to the above information,
Owner or Agent
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To Water Utility: Requirements have been m~t to purchase and
install meter(s) at the above address for size and use indicated.
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Plumbing Inspector