2231 MCDOUGALL AVE 2022-05-03 - Laserfiche WebLink

Backwater Prevention Device Property Owner Rebate Form Pleasc ��erify the following items: ��v� I am �he ov,ner of the propeRy served by lhe side setver �vhere the Backvdater Preventiun Device tvas installed. `'�*l; I��✓oil:ed with my coniractor to determine the installaliun Iocation (or the Backwater Preventiun Device. I_�nderstand that the (inat decision reyarding installation locaton ��✓as mini�. ��.ij Y the [3acF;v,�ater Prevention Device �a�as installed on my property: C- • I have been shnwn ho�v to access, inspect, and maintain my dewc� b}� my contractor • I understand the City wdl not maintain the Back��✓ater Prevention De�dice I arn exclusively respor,�ibie to maintain it and to keep it in good �vor'; i�n OfC�P.I. • If I sell my property, I�vill rnake the buyer aware of the Backti�ater Preventicn Device and the reed to mair�lain it. Cfioose one of the following: �� As rf no�a�, my property has no do�vnspouts or olher onsite draina,ye that connects to the side se�ti�er upstream of ihe insi vlled Ba,k�•,�iter Prevention De��ir.e or ;; i ��III I18VC CjOWf15�l0UiS Of OiI1P,( OI151(B ClfcLf189P, IIl7( COIIiIC'Ct5 �O U1B 51(jii ;�>�•;er upstiean�� of the installed 13ac1<��a,ur Pr��vention Device. I undcrstard that lea��ina tiiesr. cennections means thal lhe rls'; o( ilood;��g fmm do�>>nspout or onsitu drainaa�� rem;uns I ncce��t lhal risk. �Srgnat�irc �._,ti� �1L�:-.:��- �----=_Date _�� .'_',�' ) �--� '�1 Paau ? o` 2 Revi;�:l 09�0��'01�;