HomeMy WebLinkAboutWater Meter - 06/26/2013 CITY OF OSHKOSH WATER DISTRIBIJTION :
WATER METER PERMIT
(Please Print)
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Date• v L� ��'�_F �
, Meter(s) Installed At• � � � e � f� - l. �
Name of Owner: A-� �— w�, ► �r' r-� .
_ Address of Owner: _ -o� �: - S 3 Z �F�"�/ �� L � 7
Meter(s) Size• ,
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction .Typical Multi-Unit,Multiple Meter �
Single Meter �srs��sou���ss
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Typical Deduct Meter Typical Water Use Only Meter !
No siwrnuer . �te�aounoM vKwts
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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
e. For inquiries please call 236-5052.
. Met rs> 1-1/2" require a bypass.
M r s) wi b ' ed and used according to the above information.
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Signature of Owner or Agent Print Name of Applicant and Company
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