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K � <br /> • � q <br /> MULTIPLE DOI�IIESTIC VI/ATER SERVICES REQUEST FORM <br /> .�_ ..�m <br /> __�.a ..�� w...,.�. . _�.�� <br /> �� .,.��.rµ .k..���,_.w�.���..w.;. :. ..:..NUMBER;OF.$ERVI.CES.,REQUESTEDs.. `; , <br /> Selecfi Meter Size List Meter/Service Quanfiity <br /> � ❑3/4"Domestic Water Service X � - <br /> - ❑ 1"Domesfic Water Service X - <br /> ❑2"Domestic Water Service X <br /> — :. <br /> � �fifiii� i�.�1u.43u�mgle a�ici multiple metered serv�ces. �egula#�ons,and Cha�ges; _. . - LL � .} `r <br /> az <br /> Only one metered service connec.tion shall normafly be installed to a premises under single ownership. If, however, <br /> a consumer shal( request that more than one metered service be connected to a premises under single ownership , <br /> and the superintendent shall agree that the particular individual circumstances warrant such additional <br /> connection(s), the party requesting same shall make application and payment in the regular manner and such <br /> additional connectian(s)shall be considered to be solely for the benefit and convenience of the applicant.The <br /> premises shall thereafter be charged for water service through each service connection independently as though <br /> service were being provided to two or more premises, and the minimum charge and the charge for water consumed <br /> sha11 be computed separately for each meterec!service; provided that the premises shali remain fiable for a lien for <br /> water charges as provided in Section 14.16.850. (Ord. 1237-86 §43, 1986) <br /> /hereb conse f to the terms of EMC 94.96,430 lisfed above: <br /> � <br /> --7-l � <br /> Appficant Stgnature Dafie <br /> City of Everett Office Use Only <br /> Approved By: <br /> Utilities Department Authorized Signature(Required) Date <br />