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_ <br /> [3ACK�VA'I't,R VAl_,A�E AUT3IORi7.ATI0N <br /> l. P�imissi��n to Inspecl. The Owncr grants permission to the ('it�� ;md iis wnU�actur io <br /> inspcct �hc plumbing <ntd drainage of the (1����ei's propert}' for tlie purpos�� �f 2a'hrring <br /> information rcgardine whether a hack�:�xtcr vah�c should bc inslalled. l i;c City �md <br /> O�viicr u�ill cooperalc to delermine u inutuall�� ��grccablc time f�or the inspc�tion. l�hc <br /> inspc�tion iti at �lic Cih�'s �ulc cost. <br /> ? Rackwa�cr Vnl�c. <br /> A. Citv Rc��ie��� uf Ins��cction nud Pcrinission In Insinll 14ac1;���atci_Val�'c l�:w Cil�� <br /> ��ill re�•ie�: ihe results oi the inspectinn .uid will deiermine �+�hether a bacl:�vatci <br /> ��nlve should bc ins�allcd. By siEnin� this autliurirntion, lhc O�vncr granis th� <br /> City ,end i�s contractur permissiun �o install the back�vater valve if thc Cin <br /> c±ctrnnincs �hat a back�v�ucr vulvc �hould hc installed. �Ihis installation is at �h. <br /> City's snlc cost. <br /> 13. Othcr I)evices. The!�e may be other dcviccs that pro��ide es Eood a5 (or �rca�er) <br /> protcctiou Ihan a Uacl.�taler vah�c. By signin� this authorization, ,he U�vner <br /> ��rants tlie City aud i�s contractor permission to ins�all tlie other device ii�the City <br /> detcnnines that it should be instalLd. 'I'his inslallation is at the City's sole cus,. <br /> flowcver, if the O�cncr dcsires installatiun of thc oihcr device, 6ul the City ltas <br /> detennined to onl�� install .i bacl«eamr val��c. then ihe 0��-uer mn}• install the other <br /> dcaicc, and th: Cih� will rcimburse the Owner up to the installation cost of thc <br /> backwatcr��al��e. <br /> ('. Puttu_c Aqainlenanc e. Upon installation, the bacic�vatcr��al��c or other device is ihr <br /> U���ner's properh�. 7'he O���ner is ezclusivcl} responsible to mainiain il. <br /> Olitcr Reconunencled Im�oaetnenis. t\(!cr the completion of the inspeclion. !he Cih <br /> m,��� pr���ide ihc O�vner ���ith a I�st N�oiher i�comntended impro��cn�icnts to the properiy's <br /> �ilumhin�� and draina��c sysicins. �Ph� Owncr is rcspnnsiblr for dcicnnining �ch�ilirr la <br /> iiuplcmcnt Ihr rccunmicndutiuns un tlic lisf und ii�r �iti��in�� �nr iht; implementntinn <br /> (1\1'\I�: k:� <br /> -�_ ��':y� �� <br /> Sii,n�durr: 'J �_._� Sip�n,iturr: <br /> a J�'�/�'f�/���1� <br /> Sr�� � <br /> Prinlyd Namc: - - I'rin;r�l iJunie�. <br /> Z�/ 9' ,e/ �vG0L,9/ �1_ e:C+o'�. �'�7�� �� <br /> Printed i,ddrr5...- - — -!� ��l� ,�'QO��K��"v� � �D �� <br /> S/�a!-�O�"i J"�'� /r�" � � <br /> � F^/a�' � �'�� ���'� -� �� � <br /> s�.hf' �°,..E�c�'�� ��� ����'�' � <br /> ��i� <br />