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��jL�<<���iI1�IC� � � <br /> , � . . . , � ' ORIZATfON � !��V � 7 i.'u(3 J <br /> i3ACKN A 1 I�,R �ALVC AU7 fI <br /> " '�4����bt�+Q�KS <br /> I. PCf011 5 5 1 0 11 IO Insncct. 1'hc O�vncr brants �CI'1I11ti510i1 to thc City anri its � i i , <br /> I inspect lhe plumbing and drainage af ihe nwners propeitv ('or �he purpose uf gathering <br /> information rcgardin� «'hcthcr a bacic�catcr vnh-c should bc inslallcd. 'I'hc City anA <br /> O�vncr will couperatc to dctcrmine a inutually agrccablc timc lor thc inspection. 'fhc <br /> � inspcction is:d ihc City's solc cost. <br /> j 2. Ciacl:watcr V,it�c. <br /> � <br /> p. Citv Keview uf In,neelion �ind Pennicsion In Install H�icl«cnler Vnl��e. l�he Cily <br /> will revie��� the results of the insneclion and �vill determine �vbether �i backwaicr <br /> ,I c;ihc should be inst�dlcd. 6y signing this authurization, thc O�ancr grunts tlic <br /> City and itti cnntr.uior pr.nnission to inslall thc backwatcr valvc if tlic City <br /> detcrmincs th;�l a bacl:watcr volvc should bc inslallcd. Ihis inst.dlnlion is at dic <br /> City's solc cos�. <br /> �3. Other Devices. There ma} be other devices lha� prnvidc as good �� (m' grcater) <br /> prctection Ihan a backwater val�c. By signing Ihis awhurization. Ihe O�+ner <br /> �,rants llic City and its convactor permissinn to inst�ll thc nthcr dcvicc if the Cilq <br /> detennines ihat it should be installed. 'Ihis installntion is al lhe Ciry's sole cost. <br /> liowevcr, if thc Owncr dcsires inst�llation of thc olhcr dc�icc, but thz City has <br /> dcicrmined �o onl�� inslall a bacl:�valar valvc, thcn thc O�encr may install Ihc othcr <br /> Acvicc, and thc C;ity will rcimbursc Ihe (hvner up to lhe inst.illation cost of thc <br /> baclavalcr valvr. <br /> ! C. Puhue Mainten�nce. Upon insiallalion, the bacic���ater valve or mher de:�ice is the <br /> O«�ner's property. I'he(J�+�ncr is exclusivcly responsible to main�ain it. <br /> 3. Othcr Rcc�nunendeJ li�xovements. Afler the campletion o( the inspeciian, thc City <br /> ! may provide Ihe O��ncr�ti�itl� a lisl of olhcr reconunended improv�ntents lo lhe pruperty''s <br /> ! plumbin�t und drainn�;e syslems. 1'hc Onner is responsiblc for dctenninin� whclhcr to <br /> j implcmcnl thc reccnnuicndations on Ihc lisl ;md for p;iying Ihr thc implcincnl:dinu <br /> � <br /> O�VNliR: <br /> _r1`'"_��c`__—. <br /> : ��_ ���--�' - �- � - � <br /> Signal�l/c:`� Signatwc: <br /> I <br /> � ; <br /> CoE C.-l[e/uncl �'!_�4���iur ; <br /> Prinlcii�amc: -- PrinlcdNamc: � <br /> i <br /> �SIS—�C'1"��� �'-e � �;"ilE�r���� Gv�.�� <br /> � nriNed Addres��. ` <br />