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• • <br /> q(� FF./< Dr, (thuy-g) <br /> MULTIPLE DOMESTIC WATER SERVICES REQUEST FORM <br /> M a ..f? P #ui�.E �, '',!,4 ° 2 dlf M _ NZ ESTALT.��.s'A3 . hu..ih t..sit sM 0 't4i <br /> Select Meter Size List Meter/Service Quantity <br /> Mt 3/4"Domestic Water Service x Old 6 <br /> 0 1"Domestic Water Service x <br /> 0 2"Domestic Water Service x <br /> ata ani , It1 " , e x trF 'am' c dn A3 ., � t • y , sla <br /> E„ � 3kF. , ..i .7 eft s: <br /> Only one metered service connection shall normally be installed to a premises under single ownership. lf, however, <br /> a consumer shall 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 connection(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 /> shall be computed separately for each metered service;provided that the premises shall remain liable for a lien for <br /> water charges as provided in Section 14.16.850.(Ord. 1237-86§43, 1986) <br /> I hereby consent to the terms of EMC 14.16.430 listed above: <br /> V' , *fir 01 30 1 -- <br /> Applicant Signature Date <br /> City of Everett Office Use.Only <br /> Approved By: <br /> — (--(rr- <br /> tilities Departme' A t orized Signature(Required) Date <br />