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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes4 No ❑ <br /> If yes, does it have plumbing fixtures (sink,toilet, floor drain, etc.)? Yes xr No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No,Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No X Don't Know El <br /> Name: o e rk v t Y <br /> Property address: toa D C D oLt 11 ,Au?' <br /> Phone 1. :-3 �^✓0 2:7°76 (0 Phone 2: <br /> 3 0 \o� ff z��e con <br /> Email: � l • C <br />