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CITY OF OSHKOSH WATER DISTRIBUTION
WATER METER PERMIT
(Please Print)
Date: � 3 � �a
Meter(s) Instatled At: Z�-Z Z- ��,��`w�— 1��;-��`�6�
Name of Owner: �'� C'r �.�•-.��rc: c�.\� �t'v,_,.����-�-,Mc �l�-,�
Address of Owner: �_
Meter(s) Size: 3f� ` ,
Meter(s) Use: Check the Use(s) that apply.
Typical New Construction ,Typical Multi-Unit,Multiple Meter _�
Single Meter �emunonv�s
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Typical Deduct Meter 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> 1-1/2" require a bypass.
Meter(s) will be inst�lled and used according to the above information. -
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Signature of Owner or Agent Print Name of Applicant and Compan