Any person whose premises are supplied with water from the public water supply and who also has on the same premises a separate source of water supply or stores water in an uncovered or unsanitary storage reservoir from which the water stored therein is circulated through a piping system shall file with the Director of Public Utilities a statement of the nonexisting of unapproved or unauthorized auxiliary intakes, by-passes or inter-connections. The statement shall also contain an agreement that no cross- connection, auxiliary intake, by-pass or inter-connection will be permitted upon the premises.
(`83 Code, § 8-104)