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��_ <br /> ✓ <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate thal a backwater prevention device musl be mstalled on ihe sewer <br /> conneclion at the address �dentified on the enclosed loller. Please help us verify thal our <br /> inlormalion is correct by answering the(ollowing questions about your property. <br /> Do you have a basement? Yes (�No L] <br /> I(yes, does it have plumbing fixtures (sink, loilet, floor drain, elc )? Yes �No �] <br /> Do you have a backwater valve on your sewer line? Yes �] No [�Don't Know ❑ <br /> Do you have o grinder pump in your basemenl? Yes [J No �Don't Know [J <br /> Name. �IC/1Ql"CI-- J9/lG�/I ..--- <br /> Property address: C ���__�/Ve rSO� �I� <br /> Phone 1: yZS- 7SZI -S�DD Phone 2: ___ <br /> Ema�l IIICK (,� /e/� 5�� cr� L /'V1L�i/ �'DI'h <br /> —�- —��--- _ <br /> .. __ . --.-.-7-•P�. -��-- <br /> , , . � <br /> 6...�.i�...� �'1 � �i,,.� .� . <br /> , � <br /> • . : � � <br /> , � <br /> -�'---- -�--!" ------1- . _.L: _ _� 1 :.�..:;-_ . . � . ._.. _. . . _ o-.:,�.. .. . . � .. <br />