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, <br /> MULTIPLE DOMESTIC WATER SERVICES REQUEST FORM <br /> NUMBER OF SERVICES REQUESTED <br /> Select Meter Size List Meter/Service Quantiry . <br /> ❑ 31d" DomesUc Waler Service X <br /> ❑ 1" Domestic Water Serv�ce x <br /> ❑ 2" Domeshc Water Service x <br /> EMC 14.16.430 Single and multiplc metered services -Regulations and Charges: <br /> Only one metered service connection shall normally be mstalled to a premises under smgle ownership Ii, however, <br /> a consumer shall request that more than one metered service be connected to a prem�ses under single ownership <br /> and the supenntendent shall agree that ,he particular individual circumstances warrant such additional <br /> wnnection(s), the party requeshng same shall make apphcation and payment in the regular manner and such <br /> addihonal connecUon(s) shall be considered to be soleiy 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 prov�ded to hn�o or more premises, and the min�mum charae and the charge tor water consumed <br /> shall be computed separately For each metered service; provided ihat the premises shall rema�n liable for a hen for <br /> water charges as provided in SecUon 14 16 850 (Ord 1237-86 § 43, 1986) <br /> I herebv consent to the terms ol EMC f1.16.43C listed above: <br /> Applicant Signature Date <br /> ' Ciry oJ fverett OJJire Use Only <br /> Approved By: <br /> � <br /> Uti�ities Department Authorized Signature (Required) Datc <br /> .1� . ,• <br /> • � u � 1�� ' �'i <br /> • , ,.��,� .. <br /> •i.l���+ ;+!'; <br /> ., �;.� <br /> . . :. � <br />