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; - o ����U��L <br /> � oct n � zc�3 <br /> i PUBLIC WORKS <br /> I3ACKWATER VALVE AUTHORIZATION � <br /> � I <br /> i 1. Pcnnission lo InsPcct. 7'hc Owncr grants permission tq thc City and ils contractnr te � <br /> '� inspect thc plumbing and drainagc of k�c O�vncr's properry fa• the purpose of gathcring <br /> infomtation regarding whcihcr a backwatcr valvc should hc installcJ. Thc City and <br /> Owncr will cooperale lo dclennine a mu(ually agreeable time for the inspeclion. Thc <br /> inspeclion is aL ihc City's sole cosl. <br /> 2. Uackwatcr Valvc. <br /> I <br /> � A. C�� Review oi Insuection and Pennission lo Inslall Racicwa�er Valve. 'Ihe Ciry <br /> !, will rovicw the results of thc inspcction and will dctcnninc whclhcr a hackwatcr <br /> ;; valve should bc inslallcd. 13y signing lhis authorizaliou, the O�vner grants the <br /> City and ils contraclor perntissirni lo install tlic backw�dcr vAlvc if lhc City <br /> I delennincs that n bacicwater valvc should bo insudled. "I'his inslallation is al thc <br /> � City's solc cost. <br /> I3. Othcr Dcviccs. Thcrc may bc o�hcr dcviccs that providc as good as (or grealcr) <br /> proteclion than a baclavatcr vah�c, f3y signing iliis authuriz:rtiun, �hc Owncr <br /> � grams thc City and its coniractor permission ro install Ihc other device if the City <br /> I dcicrmines th:it il shoidd be inslallcJ. This inslallalion is at the Cily's sole cosl. <br /> � liowever, if thc Owner desires insmllation of thc othcr device, hut the City has <br /> � delemiined ro only install a bacicw:�ter valve, thcn Ihc Owner may install the other <br /> device, and dic City will reimburse thc Owner up to the instnllntion cost of thc <br /> ` Uad<water valvc. <br /> C. Fuluro Maintcnance. Upon inslallation, Ihc backwarter valvc or o)hcr device is the <br /> Otvncr's properly. Thc Owncr is cxclusivcly responsiblc[o mainL�in it. <br /> � <br /> 3. Olhcr'Itccummended Imorovemenls. After the completion of thc inspcction, the City <br /> �. may providc tl�e Owncr widi a lisl of uthcr rccammcndcJ improvcmcnls lo lhc propaiy's <br /> plumbing and drainage systcros. 'I'hc Owncr is responsible for detcnnining whether to <br /> ± implcmcnt thc rccomnicndat:ons un �he list.mJ far paying for Ihe implemenlation. <br /> 1 <br /> i <br /> �. 011�NER: n !y/ <br /> ' ` — G_ f__�5%Q�E4f/J!__ -- <br /> ; Si6nalurc: tiig�iaturc: <br /> d <br /> � �o���n ����L__ �'� :��, <br /> � Printcd Nmnc: Nrinted Nama <br /> i <br /> 1 �S?Z c2�1�� �/'e-- <br /> Printed Address: <br /> �,ve;r��}� �JA <br /> � �� �o i <br /> i <br /> � _ _ : <br />