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✓ <br /> BACKWATER FREVENTION;DEVICE PROGRAM <br /> Our records indicate that a backwater preventian device must he installed on your <br /> sewer connecl�.on to comply �vi�h �he new ordinance Please help us venfy that our . <br /> :n(ormation is correct by answering the followmg questions aboul yow property ; <br /> Do you have a f�asement� Yes � No ❑ II <br /> �-� �/� <br /> If yes, does d have plumbing (xtures (sink, toilet, floor drain, etc )? Yes'IXI No ❑ <br /> •�- <br /> Do you have a backv�ater valve on your sewer line? Ycs ❑ No ❑ Don'1 Know � <br /> Do you have a gnnder pump in your basement� Yes ❑ No v' Don't Know � I <br /> I <br /> Name ��1��_L�� -- I <br /> �Y�Qf� �- a _� � s _�7c�� _ <br /> Property address _ {�C i�_ �.(�J��r �Y-V`C-_ _ _ <br /> Phone 1: `� �S ' �J�a -nyj U/$ Phone 2 �(iU/_- (p 79__�5s� <br /> Finail �K����-�.(!�`-1��1% ��lLt!(+ti.��/,/l'� <br /> — — , � � — <br /> . � � .� � ! . . � 1p� . . .� .. , , ,� � <br />