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� <br /> i <br /> I <br /> ; <br /> ; <br /> BACKWATER VALVE AIfTHORIZA7'ION I <br /> 1. I?crmission m InspecL 'fhc Owncr grants permission to the City and iLs contrac;ur to <br /> i»spccl the plumbing and drainagc of ihc O�ti'ncr's property for thc purposc of gathuing <br /> informa�ion rcgarding whcihcr a badcwatcr valvc sho�dd bc installcd. 'Ihc Cily ,md <br /> Owtwr �vill cooperule to detennine a mutually ��,;recnhle time Ibr the inspectiun. 'fhc <br /> i inspcc(ion is:�t thc City's solc wsl. <br /> ' ?. pacl:�valcr_V�il��c. <br /> A. Cit1' 12c�_ie�q of Tnsncction m�d Pcrntissiun to Install Bacl;walcr Val��u. T�hc Cit}' <br /> will revietiv tLe resulis of Ilic inspecliun and �vill delermine rvl�clher a bacicwaler <br /> valvc sh�uld be ins�allcd. f3y signing this authorization, thc Owncr grams thc <br /> � Cit}' and ils contrnctor pcnnission to iustall lhe b:�ckwater ��alve if lhe Cil}' <br /> � dctcrmincs thal :+ backwatcr valvc should be installcA. '1'his inslallation is :il thc <br /> '�� City's sole cost. � <br /> � I3. Uthcr Devices. 'I'hcrc may bc other devices that prnvide �u good as (or greater) I' <br /> protcction �Lnn u bacl<u�ater ealvc. By signing this xuthori'r..+tion, the Owner � <br /> gt;+nls the City�nd ils contractor permission lu insuill lhe nllicr device iFtl�e CiYy , <br /> delermines that it should be inslnlled. This installalion is al tlic Cily's snle cnsL i <br /> lio�scvcr, if thc O��ucr dcsircs installation of thc othcr dcvicq but thc City has <br /> � dctcrmined to only install a bacla��ulcr vuh�e, then thc O�ener muy install thc olhcr i <br /> devicc, and Ihe Cit}� will rcimburse the Owner up to �he installation cost of the ;i <br /> i bacl�vatcr vitl��c. <br /> � <br /> � C. Puturc Maintcnancc. Upun installation, thc b�ckwator valvc or odicr dcvicc is thc <br /> Ownci's praperty. l'he Owner is exclusively responsihle to mainlaiu iL <br /> i <br /> 3. Otltcr_Itccommcndeci__ImProvcmcnis. A(icr Ihe completion of the inspection, Ihe City <br /> may providc fhc O�vncr with a list of odicr recommcndcd improccmcnts to Uic pruperly's <br /> plwnbing and di.�inage s}stcros. The Owne� is responsiblc lor dclermining whcthcr to � <br /> ! im�lcmcnl thc rccommcndations un!hc litt�md tor pnying fnr thc implcmcnt,dion. � <br /> � <br /> ' 011'NI?lt: ' <br /> �-�� 1 l <br /> v ,;- <br /> � �,�f,�� _ .�: C _ ,�-��t- - -- <br /> ' 'titgiudur}� Si��.naturc: <br /> i l <br /> i f <br /> : <br /> ! � ( �Z C(,1'1(�,��- _ 1' liS��YL - -- - -- <br /> � I'riiite�i N3ii�e: Printcd N;cme: <br /> I 7 � <br /> �3 ' � � �f- :����e ,-- o [�C��a�L� � <br /> Yrintcd Address: C� L�D <br /> � OCT 17 2013 <br /> ; pU��,�c woRxs <br />