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HomeMy WebLinkAboutWater Meter Permit (02/04/13) CITY OF OSHKOSH WATER DISTRIBUTION WATER METER PERMIT (Please Print) Date:b i'ot Meter(s)Installed At: 2-q Name of Owner: T t5A4 c Address of Owner: j f12> N tr51' ;%), Dn. At/A' sa 5`5. 9/5 Meter(s) Size: :5P-1 6 Meter(s) Use: Check the Use(s)that apply. • Typical New Construction ,Typical Multi-Unit,Multiple Meter Single Meter ,OIRaounaNwwo • ONOMNOE 70 annum imam roNflacs.YAWL J - si �s waB�wCON1Na.vAtte R a/SWUM'aw n Typical Deduct Meter Typical Water Use Only Meter No iM/fARR menet11CLAMS VW= !MR aNciaANae as omaneTO ALLOwla SWUM OMR 1 ND&ANNAN? ,Air„ 71 COCNANON TO • SMfMYswot 4.. - , • NYLaN10Catl1Nat•NAM . • taut tff.304 l VMLVe= 1M- COMM VANE 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 and used according to the above information. Signature of Owner or Agent Print Name of Applicant and Company 5eS e SID-x+33