HomeMy WebLinkAboutWater Meter - 11/15/2004CITY OF t3SHKOSH WATER DISTR.IBUTI~N
WATE1t METER PEIi:MIT
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Date: i/-/s °~
Meter(s) IInatalted At: /~ ~~~~ ~T
Name b! Owoes: ~ ~ ~
Addrar of Owner: r y ~ * „~.., .,. S 7'`„
Meter(s) Siace: .,.._~.,~,(Y~-
Meter(s) Use: C6ak the Ure(a) timt apply.
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Single Meter ~r.
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. Typical Mu1ti•Uni~, Multiple Meter _..."
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Typical Deduct Measr
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Note: ~ 1. A Plumbing Petnsit may br required prior to the install~or- of the isatud water
meter(s). .
' 2. All plumbing tntnt be conducted by a Wisconsin Licensed Plumber, except s h~tne
owner may perfomt his/her own plumbing within their single thmily, owner occupied
home. For inquiries please call 236-5052.
3. Mater: >_ 1-1/2" roquiro a bypass.
Meters}yviU be instidledsad m~ according to the above informadon.
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Signattue of Owner or Agent
Voter Uae Only M
Print Name of Atmlicant and
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