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METER(S) PERMIT
Date /.--* V ' r "'qO
Name of Owner
Address of Owner /
Meter Installed At d1 �,/.',0,�/;
Meter(s) Size 1 j4
Meter(s) Use
/it ('Diagram of Use)
Meter will be installed and us-- -ccording to the above information,
// . i . e
Owner or Agent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
PP umbing Inspector