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Backwater Prevention Device <br /> � �� Property Own�r Rebate Form <br /> Piease veri(y thr_ following items: <br /> j�,}'I am the ov��ner of the property served by U�e side sevder where the Backv�ater <br /> Prevention Dewce was insialied. <br /> �; I ti�dorked v.�ith my contr�ctor to determine the installation location for the Backv✓ater <br /> F'�evention Devire I under�land that lhe final decision regarding installation locaiion <br /> ::as mine <br /> �� li ;f:r; �ack�r�a,er Prevenlion Device �vas mstalled on my property� � <br /> • I have been shown hovd to access, inspect and maintain my device by my <br /> contracior <br /> • I understand the City will not mainlain the E3ackvrater PreveMion Device. I <br /> r:m exclusiveiy responsible to maintain it and to keep it in gocd v�orking <br /> order <br /> • �I I sell my nroperty, i will make the buv�r a�^rar : of the Back�vater <br /> °revcntion De��ice and the need to main?ain il <br /> Choose ane of the foliowing: <br /> �✓�As ef no���, my property has no downspouts or other onsile drainage thal connects to <br /> ;h�: slde sc:�ver upstream of lhe instailed Backwater Prevention Device. <br /> rx � <br /> — I stili havc dcw�nspouts or other onsite drainage that connects to the side se�,��er <br /> �,rps;ream of the insta!Ied E3ack�aater Preventioi� Device. I understand thal leaviny these <br /> �nneclions means ihat the risk o(floodin� frorn downr.pout or onsitc �frainage remains. ' <br /> i �,:�::�:i,� in;�� ��,,�n � <br /> Si�nalurc_ 'tl'."���/------ -- Date _ �'� 7�—�� <br /> - -..... -r— -- <br /> Paoz . _.(; � <br /> I?rvue;:1 Co�i c;:7�'.: <br />