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5501 COLBY AVE 2022-04-14
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5501 COLBY AVE 2022-04-14
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Last modified
4/14/2022 9:06:55 AM
Creation date
4/14/2022 9:06:28 AM
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Address Document
Street Name
COLBY AVE
Street Number
5501
Notes
BACKWATER VALVE
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Backwater Prevention Device <br />Property Owner Rebate Form <br />Please verfiy the foilowing items: <br />� I am the owner of the property served by the side sewer where the Backwater <br />Prevention Device was installed. <br />Bj I worked with my contractor to determine the installation location for the Backwater <br />Prevention Device, I understand that the final decision regarding installation location <br />was mine. <br />� If the Backwater Prevention Device was installed on my property: <br />• I have been shown how to access, inspect, and maintain my device by my <br />contractor <br />• I understand the City will not maintain the Backwater Prevention Device. I <br />am exclusively responsible to maintain it and to keep it in good working <br />order. <br />• If I sell my property, I will make the buyer aware of the Backwater <br />Prevention Device and the need ta maintain it. <br />Choose one of the fr�llowing: <br />� As of now, my property has no downspouts or other onsite drainage that connects to <br />tne side sewer upsiream of the instailed Backwater Prevention Device. <br />or <br />❑ I still have downspouts or other onsite drainage that connects to the side sewer <br />upstream of the installed Backwater Prevention Device. I understand that leaving these <br />connections means that the risk of flooding from downspout or onsite drainage remains. <br />I accept that risk. <br />Signafure � Date �/9(' y <br />Page 2 of 2 <br />Revised 09/09I2014 <br />
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