It seems like such a huge amount of water and would require so much energy to get it that high, plus there’s the waste to deal with

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    252 months ago

    Plumber here. Unless we’re talking about sky scrapers the grid pressure is generally enough to lift the water to the top floors. As long as it’s lower than the city water tower there’s no issue. If it’s a flat terrain or the building is on a hill then yes, you might need a pump to boost the pressure. Sewage on the other hand is not an issue - gravity takes care of that.