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Backwater Prevention Device <br />Rebate Increase Authorization <br />Property Address: 5026 Colbv Ave <br />City: Everett State: WA Zip: 98201 <br />Property Owner Name: FORREY. MELVIN J 8 HELEN V <br />Email Address: UNK Phone: 425 512 8805 <br />Contractor Company Name: Moen Ptumbinq <br />Estimated cost of BWD Installation: SS.000.00 <br />Total Ftebate Cost Authorized by City of Everett: S4.000.00 <br />Justiflcation: 51de sewe� located at 10 foot of depth outslde house. Portion of <br />side sewer under house additlon and landscape rockery. Inside backwater valve <br />will require installadon of 2 back water valves and restoration of a finished floor. <br />Authorized By: <br />Revised 9/10/14 <br />