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i <br /> ���� Backwater Prevention Device ; <br /> ` EYF rr Property Owner Rebate Form <br /> Plea e verify lhe following items: ' <br /> lY I �m the owner n( the propmty s<:r�ed tiy t'�e sidc sewe� �vh�:rc� Ih�� Backv✓ater � <br /> ('revenbon Uevice was installed ' <br /> i <br /> �� �I �vorked a�ith my contraclor to deturmine ihe installation locatiun f�r the Back�vate� � <br /> 1Prevention [7evice I understand that the final deiasion ic;gardmg ins�allalion IocaUnn <br /> wa: mine <br /> , � I( U•�e; L3ac,�vater f-revenlion Devic�� was mstalled on my property '. <br /> . I nave been shovdn hnw to acr.rss, mtpeci, �nd mamt�in my devicr. by my <br /> r,oni�8ctor � <br /> I understand the City vn'I no� mnintain the E3ackwatei Pieventinn Dewcc� i � <br /> • ar�i exciusrvely responsible lo maintain it and to k��ep il in good vioik�ng � <br /> order. <br /> . I( I seH rny property, I will makt: the buyei �warc of thr, f3ackwaler <br /> Prevm�Uon Device and the need lo mainlain it <br /> Cho se one oF the (ollowing: ' <br /> ;�, o( nu�v, my property h-�s no r,o�-nspouts cx other nnsitr. dramage ihat connects tu � <br /> ihe side sc�a-ei upshc�nn of thc �nslrill�:d f3ar.k�vater PrNvenlion f]evir.e <br /> r�r <br /> i <br /> � � I .^,hll have dn�vnspouls ni nther onsde clriin��ye th�l conner,ts ;o the side sewur <br /> uG�streeim oi ihe mstallc�d Buck�vatei f'ievenhon Ih:vic� I unders�ani! Ihdl leawny these � <br /> i.�mn��chonr: nu�;ins Ih�it thu �isk o(floodin,y Rotn dnwnspo�.,t or unsi;N drninage rcriains I <br /> I r�r.ci�pt lh+ji iis4� � <br /> � �� ' 1 <br /> Slynatrnc_� l� �.%��/C.��---� D�fe�x. G �'� <br /> - -- - - - -- ---- -- / --- <br /> / <br /> i <br /> I <br /> i <br /> I'agc 2 r(2 � <br /> k���is�:d t;s;,�u;m�a � <br /> � <br />