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1630 LOMBARD AVE 2022-04-29
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1630 LOMBARD AVE 2022-04-29
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Last modified
4/29/2022 2:40:27 PM
Creation date
4/29/2022 2:38:29 PM
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Address Document
Street Name
LOMBARD AVE
Street Number
1630
Notes
BACKWATER VALVE
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Backwai;er Preventio� Device <br /> � Property� Owner Rebat� Form <br /> Please verify the following items: <br /> �2m the own�r of the property served by the side sewer v✓here the Backtvater <br /> Prevention Device vdas installed. <br /> � vdorked with my contractor to determine the installation location for the Backwater <br /> Prevention Device. I understantl that lhe final decision reyarding installation location <br /> �:�as ine. <br /> � If the Back�vater Prevention Device was installed on my prooerty: <br /> • I have been shoi�dn how to access, inspect, and maintain my device i�y my <br /> contractor <br /> • I understand the City will not maintain the Back�vater Prevention Device. I <br /> am exclusively responsible to maintain it and to keep it in good tivorking <br /> order. <br /> . If I sell my property, I will make the buyer aware of the Backv✓ater <br /> Prevention Devicc and the need to maintain it. <br /> Chaose one of the following: <br /> As of nov��, my property has i�. �o�vnspouts or other onsite drainage that connects to <br /> the side sewer upstream oi the in.. _Iled Backwater Prevention Device. <br /> ar <br /> [) ; still have downspouts or otiier onsite drainaye that connecis !o the side sevder <br /> upsiream of the installed Baclavater Prevei�tinn Device. I understand that Ir,aving lhese <br /> cennections means that the risk of flooding from downspout or onsite drainage remains. <br /> I acc�pt that risk. <br /> ,._'" -- ' � <br /> , Sigrtature �_�?��� _ Date�zl /S __ <br /> Page 2 of 2 <br /> Revised 09!091201�i <br />
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