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CITY OF OSHKOSH WATER DiSTRIBUtION
WATER ME'TER PERMIT
(please Print)
. Date:J"LJL -( 7-0/0L(
Meter(s) Installed At: 3i~ a. K 0 E:.LI -~ aT
Name of Owner: 1-Av (J t'/lf\ f'\..V:.. ?L I-A. LA, .
Address of Owner: PO' 'GdlG- ;L?uC;, OSH iCo<;.l-/ S'1 q (} '5
Meter(s) Size: :-3 (y ,
Meter(s) Use: Check the Use(s) that apply.
Typical New construction~' .' .
Single Meter
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. Typical Multi-Unit, Multiple Meter
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Typical Deduct Meter
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Typical Water Use Only Meter
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-.DIG COImICX. VALVE .
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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 hgme
owner may perform hislher own plumbing within their single family, owner occupied
home. For inquiries please call 236-5052.
3. Meters 2:: 1-112" require a bypass.
,5~.wilbe .. ~~d acco.rding to the aboV~. infO. rm. ation.
h . ~ O~l. I-lNJ$FiJ,
Signature of Owner or Agent Print Name of Applicant and Company