La Mesa, CA · San Diego County

No notary required

Backflow Prevention Program Reimbursement Instructions

La Mesa property owners use this packet to apply for reimbursement for an eligible sewer backwater valve installation and submit required supporting documents.

What this form is

This packet explains the steps La Mesa property owners must complete to seek reimbursement for installing a sewer backwater valve, and includes the Backflow Prevention Program Agreement. It describes required estimates, permits, inspection records, and payment documentation; the city requires these items before authorizing reimbursement. The agreement asks for the property owner’s information, signature, and date.

Who needs it

La Mesa property owners required to install a sewer backwater valve and seeking reimbursement should complete the agreement and provide the required documentation.

How to submit it

Submit the completed agreement and required documentation to the Backflow Prevention Program administrator at 8130 Allison Avenue, La Mesa, CA 91942, or at La Mesa City Hall at the same address.

About notarization

This document is signed and dated without a notary; the property owner signs the agreement and no notarized or sworn attachment is specified.

How to submit this form

  1. 1

    Download the Packet

    Download the Backflow Prevention Program Reimbursement Instructions and attached agreement.

  2. 2

    Complete the Agreement

    Fill in the property owner and contact information, then sign and date the agreement.

  3. 3

    Gather Required Documents

    Provide the estimates and other required records, including the signed inspection card and proof of payment with an itemized invoice.

  4. 4

    Submit to the City

    Send the agreement and required documentation to the program administrator or La Mesa City Hall at 8130 Allison Avenue.

Frequently asked questions

Do I need a notary for the Backflow Prevention Program Agreement?
No. The property owner signs and dates the agreement; the packet does not specify a notarized or sworn attachment.
How do I submit the reimbursement documents?
Send the completed agreement and required documentation to the program administrator at 8130 Allison Avenue, La Mesa, CA 91942, or deliver it to La Mesa City Hall at that address.
What documents are needed for reimbursement?
The packet lists three written estimates, a completed agreement, a signed inspection card, and proof of payment with an itemized plumbing invoice. A notice to proceed and plumbing permit are also part of the process.

Need something notarized?

This Backflow Prevention Program Reimbursement Instructions doesn’t need a notary — but if you have another La Mesa form that does, a commissioned online notary can help.