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MULTIPLE DC)MESTIC 1NATER SERVICES REQUEST FORM <br /> NUMBER OF SERVICES REQUESTED <br /> Select Meter Size List MeterlService Quantity <br /> ❑ 314" Domestic Water Service X <br /> �1 1" Domestic Water Service X 1 <br /> ❑ 2" Domestic Water Service X <br /> EMC 14.16.430 Single and multip(e metered services-Regulations and Gharges: <br /> ^n!y ane me:ered ser�esce conn�ctior sf;all not-mally be ir,stalled ;a a pramises untler single o;r�nersh;p. If, ho�rret�er, <br /> a consumer shall request that more than one metered service be connected to a premises under single ownership <br /> and the superintendent shaEl agree thai the particular individual circumstances warrant such addi#ional <br /> connection{s), the party requesting same shall make application and payment in the regular manner and such <br /> additional connection{s) shall be considered to be solelyfor the benefit and convenience of the applicant. The <br /> premise5 shall thereafter be charged for water service through each service connection independentfy as though <br /> service 4vere being provided to two or more premises, and the minimum charge and the charge ior water consumed <br /> shall be computed separately for each metered service; provided that the premises shall remain liab[e for a lien far <br /> water charges as provided in Section 14.16.850. (Ord. 1237-$6 §43, 1986) <br /> 1 herebV consent to the te�ms of EMC 14.15.430 lisfed above: <br /> 3-4-16 <br /> Applicant Signature date <br /> City of Everett Office Use�nly <br /> Approved By: <br /> Utilities Department Authorized Signature{Requiredy Date <br /> ���' <br />