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Backwater Prevention Device <br /> Property Owner Rebate Form <br /> Please verify the following items: <br /> Z <br /> ( I dam the owner of the property served by the side sewer where the <br /> Prevention Device was installed. Backwater <br /> worked with my contractor to determine the installation location for the Back <br /> Prevention Device. I understand that the final decision regarding installation locat oner <br /> Vasine.he Backwater Prevention Device was installed on my property: <br /> • 1 have been shown how to access, inspect, and maintain my device by my <br /> contractor <br /> • 1 understand the City will not maintain the Backwater Prevention Device. I <br /> arm exclusively responsible to maintain it and to keep if in good working <br /> order. <br /> • If I sell my property, I will make the buyer aware of the Backwater <br /> Prevention Device and the need to maintain it. <br /> Choose one of the following: <br /> ❑ As of now, my property has no downspouts or other onsite drainage that connects to <br /> the side sewer upstream of the installed Backwater Prevention Device. <br /> or <br /> f If still have downspouts or other onsite drainage that connects to the side sewer <br /> upstream of the installed Backwater Prevention Device. I understand that leaving these <br /> connections means that the risk of flooding from downspout or onsite drainage remains. <br /> I accept that risk. <br /> i. <br /> Signature �t = Date <br /> Page 2 of 2 <br /> Revised 09/0912014 <br /> 1 <br />