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METER(S) PERMIT
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Name of Owner ( sl,< / ,r e,< r 0 1/
Address of Owner ( - — (..-/—,e 1 7 ,
Meter Installed At
Meter (s) Size
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Meter (s) Use iir 7/4/ Zr � /.E' u >c
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(Diagram of Use)
Meter will be installed and used according to the above
information, °h
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ar-agent
To Water Utility: Requirements have been met to purchase
and install meter (s) at the above address for size and use
indicated.
tiPlumbing Inspector