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. _ -- - -- _.. i <br /> �, �n�������v� � <br /> �I � NOV 1 3 2013 I <br /> ' i3ACKV1'ATGR VALVG AUTHORIZATION I <br /> ?�.JBLIC WORE�.S <br /> I. Ycnnictiion tn ins�ct. 'I'hc Owncr grant5 permission to thc City :u�d its cuntractor to I <br /> inspcct thc plumbing and drainagc of tfic Owncr's property for Uic puiposc oP gathcring <br /> � iuformation regardinE whelhcr a backwatcr valvc should bc installcd. Thc City m.d <br /> On•ncr will cooperatc to dctcnninc a mutually agrecalilc [imc Cor Ihc inspcction. 'Chc <br /> inspeclion is at tl�c Cily's solc cost. I <br /> 2. Rackw�ater V�Iv_c. � <br /> A. C.� Rcvicw nf Insnatirn� ngcl Pcnnissiou t�Tnstall Rackwaicr_Valvc. "ILc City <br /> will rcvicw thc results of thc inspcetion and will dctenninc �elicthcr a br.cl,lvatcr <br /> valvc sl�onid 6c installcd. Ry signing diis �mtliorization, ihc Owncr grants thc <br /> City �u�d ils contractor permission to insfall lhe backwater valve if thc City <br /> dctcrmiucs that a bad:watcr valvc should bc installcd. 'I'his installation is at d�c <br /> City s solc cost. <br /> � B. Olher Uet�iccs. 'Pherc nmy bc othcr devices lhat proeide as good as (or grcatcr) <br /> protcction than a baclovatcr valvc. Liy signiug this audiori�ation, tltc Owner <br /> gruils ihc Cily aud its contr;.ctur pennission tn inst�ll thc oqicr dcvicc i(ihc Cily <br /> detcrmines that it shnuld be installed. "I'his installation is at thc City's solc cost. <br /> Iiowcvcr, if dic Owncr desirc.e installatian uf the other devicq bnt the City lias <br /> � dcicmiincd to only install a baclav��ter valvc,thcn thc Otvncr may install thc othcr <br /> dc��icc, vid tl�c Cily will rcimburse Ihc Owncr up to thc installation cust uf p�e <br /> back«�atcr valve. <br /> C. Fuwre Maintcnance. Upon instalJatiou,tiie back��•ater val��e vr ott�cr devicc is the <br /> Owner's property. '1'he Owner is exclusively res�onsiblc to m��iuWin it. � <br /> I 3. Otlier Recotnmended lmnrovemenls. After lhe camplclion uf the inspcction, lhe City <br /> may providc H�c O�vncr���ith a list o(othcr rccommendcd improvcmcnts to thc properl}�'s <br /> plumbing .md drainagc systcros. 7'hc Ott•ncr is responsiblc for dctemiining rvhcthcr to <br /> � implcmcait thc rccommcndations on thc list�nd fin paying fim ihc implcment�+tirni. <br /> I O�I'Nk:lt: ' <br /> � �v1� 1/����. � / � ��ii <br /> Iignalurc: Sigiudiuc: -- � - - -- <br /> I <br /> MAR�r -F�������IN11 �To�l _ <br /> 1'rintcd Namc: Printcd N�mc: <br /> � 30S _ cJL/1U (�5�1'U� EUC��i f_ (�il�i- `�T'��� <br /> � Printcd Address: <br /> �' � <br /> �• ���• <br />