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METER(S) PERMIT
Date
G- 4- 9'z
Name of Owner RD/vAL4 ,:X'>Y...C7)2:
Address of Owner Z Z ZcO /~//c'/S Q/vr :::)r
Meter Installed At ::)75- /ox r'/R~ ~k,
Meter (8) Size 34/1 d Z:s-
Meter(s) Use e?O~~s77C
1" a!/:J/Ck;~;t .I??1IZi''l! -O/$;r: TO :5Art/.
~ /( ?7ZS--l?-?!7/:/z $~125/
1'1. tV p1,o~d ~77'le ~;V/ce--
(Diagram of Use)
. Meter will be installed and used according to the above
information, .
~crd
Owner ()r Agent
To Water Utility: Requirements have been met to purchase
and install meter(s) at the above address for size and use
indicated.
Plumbing Inspector
.+