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MULTIPLE DOMESTIC WATER SERVICES REQUEST FORM <br /> NUMBER OF SERVICESREQUESTED <br /> Select Meter Size List Meter/Service Quantity <br /> ❑31.4"Domestic Water Service X <br /> lei 1"Domestic Water Service x 1 <br /> ❑2°Domestic Water Service X <br /> EMC 14.16.430 Single and multiple metered services-Regulations and Charges;: <br /> Only one metered service connection shall normally be installed to a premises under single ownership. If, however, <br /> a consumer shalt 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 14.16.860.(Ord. 1237-86§43, 1986) <br /> 1 hereby consent to the terms of EMC 14.16430 listed above: <br /> 4-5-16 <br /> Applicant Signature Date <br /> • <br /> City of Everett Office Use Only <br /> Approved By: <br /> Utilities Department Authorized Signature(Required) Date <br />