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MULTIPLE DOMESTIC WATER SERVICES REQUEST FORM <br /> � <br /> NUMBER OF SERVICES REGUESYED <br /> Select Meter Size List MetedService �uantity <br /> ❑ 3/4"Domestic Water Serv!ce X <br /> ❑ 1" Domestic Water Service X <br /> ❑ 2"Domeslic Water Service 'C <br /> � <br /> EMC 14.16.430 Single and multiple metered services -Regulations and Charges: <br /> Only one meterad service connection shall normally be installed lc a premises under single ownership. If, however, <br /> a cons�mer shall requesl that more lhan one metered service be connected to a premises under singie ownership <br /> and the supermtendent shall agree that the particular mdiwdual circumstances warrant such additional <br /> connection(s), lhe party requesting same shatl make application and paynient in the regular manner and such <br /> additional connection(s) shall be considered to be solely for the beneflt and convenience of the apphcant The <br /> premises shall thereafter be charged (or water service through each service connechon mdependently as though <br /> servlce were being prorided to hvc or more premises, and the minimum charge and the charge for water consumed <br /> shall be computed separately for each metered service; provided that the premises shall remain Gable for a Gen for <br /> water charges as provided in Section 14.16 850 (Ord 1237-86 § 43, 1986) <br /> 1 herebv consent to the terms of EMC 14.16.4301isted abovc: <br /> =-ApplicantSignature i Date <br /> � <br /> City of fverett 0/jice Use Only <br /> Approved By: <br /> Utilities Department Authorized Signature (Required) Date <br />