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BACKWAT�R VALVE AUTHORIZATION <br /> 1. Pcimission to Insgect The Owner grants pemussion to the City and its cou4actor to <br /> inspect tkie pl�unbing and drainage of Aie Owner's property for lhe purpose of ga4iering ; <br /> informzfion regarding wliether a backwatcr valve should be installed. The City and , <br /> Owner will cooperate.to detetmine a mutually agreeable lime for dte inspection. The <br /> u�spectian is et.the City's sole oost i <br /> 2. Backwater Valve, � <br /> A. G�ri'Rei�iew of Lrscection snd Pertnission to Install Backwaler Valve. The Ciry <br /> will review.the-results of the inspc�ction and wili determine whether a backwater <br /> valve shou}d be installed. By si@ning this authorization, the Owner grants the <br /> City and its contractor permissic-� to install the backwater valve if the City <br /> ddermines that a:backwater valve s�,uld be installed. This iustallarion is at the <br /> (Sty's sole�ost <br /> II. Other Devices. "There may be othar devices iliat provide as good as (ot greater) <br /> �Sotection then a beckwater valve. By signing this autl�orization, tlte O�mer <br /> grants t6e Cily and ils contractor pertnission to install the other device if the City <br /> detetmmes thal il should be installed. This installation is at tl�e City's solc cost. <br /> However, iPthe Owner desires installation of ihe other device, but Uie Ciry has <br /> detemined to only install a bacicwater valve,then the Owner may install the othet <br /> device, �d the City aill reimburse the Owner up lo the installation cost of the <br /> � backwmer valve. <br /> C. Futu[e Meintcnance. Upon installation, thc backwater valve or o4�er device is the ' <br /> Oarner's property. Thc Owner is exclusively responsible to maintain it. <br /> 3. Other Recommended dmurovements. Afier lhe complction of the inspection, the City <br /> may provide lhc Owner witli a list of oUier recommcndcd improvements f �ihe properiy's <br /> plumbing and drainage systems. Thc Owner is responsible for determining whcther to <br /> � implemcnt the reconunendations on Qie list and for paying for ihe implementation. ' <br /> OWNER: ` <br /> - � . \ <br /> � Signature: Signature: <br /> � <br /> � <br /> i I'�.u'��-�-. C.�ikT �/77�(� �V� <br /> Yrint�e: Printed N;une: <br /> I <br /> � J/.?e� /� pnd.�.�3Cc <br /> ; Printed Address: <br />