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Name of Owner; -
AddreSS•of Oda;
M~er+(i) Sizes
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WATER METES PE~;1V~
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. Typical New ConaRucdoa .
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Typicnl D~act.M~`~`
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TYP~~aI Mdti-U~ ~~la Meter
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Typicnl wader Use only Meter
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Moue: 1. A Plumb~~ ~ ~ the '
meter(s), ~ ~Y ~ reciuined prior to msrtallation of the issued water
2• Ail plcuabiag must be coed
~, acted by a Wisconsin L'
~' Pmform his/her ovvn plumb• used Plumber, except a home .
home, for ingttiri~ p1q~ ca11236.5052=~•~~ heir ~ o
3' M~ ~ 1`1!Z" equine a bvpa~• Y~ wt:ar occupied
Metlfe~(s) will be instsdled end used aecordittg m the zbove ~formattoa.
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Sim of Owner or Agent ~ ~ ~ - 1lS~i-- c
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. Pent N App cant ~ Company ,p~ ~ /• T
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