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HomeMy WebLinkAboutWater Meter - 12/23/03CITY OF OSHKOSH WATER DISTRIBUTION WATER METER PERMIT (Please Print) Date: l Z3 c~ Meter(s) Installed At: 13 ~I O J ~ d~ L~ e ~'~,,~.-.+ Name of Owner. '~"• ~ 2 ads •-s Address of Owner. 1 ~o fit: ~ve,,r V-~- Meter(s) Size:_~ 4 ~ Meter(s) Use: Check the Use(s) that apply. Typical New Construction Single Meter Typical Multi-Unit, Multiple Meter eairee eaouioeeweu~ seeseeeeot~o fa~wrwe+raewe~ esrae^awtavw,ero ~/ awr*wtvst~t ~_ auaaaeo eaereeeoe.vKwa Typical Deduct Meter ea aiwriwtt :woe oetsennaa oesoeweaazo ` ~~ ~~~ .4 ~ Typical Water Use Only Meter Moa~wrMr twee e~aoweoa ~+~ . ~~ ~ :~ .' ~ aueowaooeeeaocvwlvE . ` DER iL'~AYa11 VALVp ~ . `tusano e[wrstx Yswa 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 home owner may perform his/her own plumbing within their single family, owner occupied home. For inquiries please ca11236-5052. 3. Meters > 1-1/2" require a bypass. Meter(s) will be installed and used according to the above information. C. Signature of Owner or Agent ~t-~-. c~ C3't~A t Print Name of Applicant and Company