HomeMy WebLinkAbout2013-Water Meter Permit 04/09/20.13 TUE 12: 38 FAX 920 733 2713 Waters Plumbing 0002/003
CITY OF O SIIKO SCI WATER DISTRIBUTION
WATER METER PER MIT
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(Pease Print)
. Date: 11 A//3_ •
:Meter(s)Installed At: 11...5-0 &'y Id t- LJ O A ,1 Dr•
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Name of Owner:/Niat�.)Cir n
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Address ofOwncr: •019(U Um ye,rs4l S . Os l+KoL" i , /4-9, . S.il?oy
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Meter(s)Size: _ 4 y u, - -...---- _. • .� _,.. . , ____•__
Meter(s)Use Check the Use(s)that apply..
Typical New Con ictiorn V : ,Typical Multi-Unit,Multiple Meter Single Meter Iwo Neummovium m
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Typical Deduct Mleter. Typical Water Use Only Meter ..,
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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> l-1/2" require a bypass.
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Meter(s)will be installed and used acc0ri4 '- ••■ the above information.
Sig/nati.vre c��ff Owner or Agent .
f Print Name of Applicant and Company