Mayfield, OH · Cuyahoga County
Backwater Valves Dye-Test Checklist and Affidavit
This one-page form lists areas to be dye tested and certifies sewer installation practices, for property owners and contractors submitting information to the Mayfield Village Building Department.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The checklist identifies downspouts, yard drains, window well drains, catch basins, and basement sump pumps for dye testing. In the affidavit, the property owner and contractor certify that sanitary waste and storm water systems are separated and state how and when the system was checked for cross-connections. The form is addressed to the Mayfield Village Building Department and is used to document sewer installation compliance.
Who needs it
Property owners and contractors involved in a sewer installation use this form to list areas tested and certify proper construction for the Building Department.
Why it needs a notary
The form contains a subscribed-and-sworn jurat; the property owner and contractor signing the affidavit should sign before a notary public.
How to get this notarized
- 1
Download the Form
Get the Backwater Valves Checklist of Areas to be Dye Tested and Affidavit of Proper Construction.
- 2
Fill In the Details
Mark applicable areas and enter the installation, test method, date, and contractor information.
- 3
Book an Online Notary
Arrange a remote appointment with a commissioned online notary for the sworn affidavit.
- 4
Sign on Video
The property owner and contractor sign the affidavit before the notary during the online session.
- 5
Submit to the City
Send the notarized form to the Mayfield Village Building Department.
Preview the form
The blank PDF straight from Mayfield. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the backwater valves checklist and affidavit?
- List the areas checked, complete the sewer installation and testing details, and have the property owner and contractor sign the affidavit before a notary. Submit the completed form to the Mayfield Village Building Department.
- Do I need to sign this form in front of a notary?
- Yes. The form includes a subscribed-and-sworn jurat above a notary public signature line, so the affidavit signers should sign before the notary.
- Can I use an online notary for this Mayfield form?
- Ohio law has authorized online notarization by Ohio notaries since 2019. A commissioned online notary can notarize the affidavit remotely; confirm with the city or village if unsure.
- Where do I submit the completed form?
- The form is addressed to the Mayfield Village Building Department at 6622 Wilson Mills Road. Contact the department to confirm its preferred submission method.