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METER(S) PERMIT
Date
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Name of OwnerfCi 'r)(:~_ () }",.l
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Address of Owner
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Meter Installed At
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Meter(s) Size
Meter(s) Use
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Meter will be
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;.-r,'Owne~i: 01:' Agent
above information,
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
Plumbing Inspector