HomeMy WebLinkAboutWater Meter Permit CITY OF OSHKOSH WATER DISTRIBUTI
ON
WATER METER PERMIT
(Please Print)
Date: iU/cx/p
•
Meter(s) Installed • t:_ D______11 -_ Dt
Name of Owner: !„1 AA d. ,
Address of Owner: �`, `a`
tr � Ct�/�e-.�. � Ll4s 4 � /1 e�.
Meter(s) Size: 3/Cf
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction • Typical Multi-Unit,Multiple Meter
Single Meter
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Typical Deduct Meter Typical Water Use Only M
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SEWER DRICHARGE Aupl�p aT0 Tdl�ATION HALM
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SEWER DISCHARGE
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IIAANTARY SEWER
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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 call 236-5052.
3. Meters> 1-1/2" require a bypass.
Meter(s) will be installed . d used according to the above information.
Signature of Owner or Agent Pr , /i . i'l -rc /4 47
Print Name of Applicant and Company
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