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MULTIPLE DOMESTIC WATER SERVIC�S REQUEST FORM <br /> NUM6ER OF SER�/ICES REQUESTED <br /> Select Meter Size List MetedService �uantity <br /> ❑ 3/4"Domestic Water Service x <br /> ❑ 1" Domeshc WaMr Service X <br /> � 2" Domeshc Water Service x <br /> EMC 14.16.430 Single and multiple metered services -Regulations and Charges: <br /> Oniy one metered service connection shall normalty be mstalled to a premises under single ownership It, however, <br /> a consumer shall requesl that more than one metered service be connected b a premises under smgle ownership <br /> and the supenntendent shall agree that ihe particular mdividual circumstances warrant such addihonal <br /> connection(s), Ihe party requesting same shall make application and payment in ihe regular manner and such <br /> adddional connection(s) shall be considered [o be solely`or lhe benefit and convenience of the appli�ant The <br /> premises shall ihereafter be charged for water service through each service connection mdependently as though <br /> service were being provided to two or more premises, and the minimum charge and U�e charge for water consumed <br /> shall be computed separately (or each metered service; provided that the premises shall remam liable for a 6en for <br /> water charg,,s as prowded m Sectwn 14 16 850. (Ord. 1237-B6 §43, 1986) <br /> I herebv consent to the terms o/EMC 14.16.430 listed above: <br /> Applicant Signature Date <br /> Gty o/Fverett UfJire Use Onl y <br /> Appraved By: <br /> Utilities Department Authorized Signaturr. (Reyuired) Date <br />