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�-- �-� - <br /> BACKWATER PREVENTION �EVICE PROGRAM <br /> Our records indicate that a backwater prevention device musl be instalted on your <br /> sewer connection to comply wilh the new ordinance. Please heip us verify that our <br /> intormation is correct by enswering Ihe following questions aboul your property: <br /> Do you have a basement? Yes ❑ No ❑ <br /> If yes,does it have plumbing fiztures (sink, toilet, floor drain, etc.)7 Yes � No ❑ <br /> Do you have a backwaier valve on your sewer line� Yes ❑ No Q Don't Know � <br /> Do you have a grinder pump In your basemenl7 Yes Q No 0 Don't Know [� <br /> Name: �P.rY l �-1�v��OLt,IrC �/ <br /> Property address: �OZ U I,QAQl� Sl ' <br /> F Phone 1: �,s 339- S��e Phone 2: <br /> Email: Cl �JU.V( � �l� � . GL^M � �� N� U�i TL`� <br /> � �� . , � . i' � � ! �,�i S ' S <br /> � , � '�, L,, <br /> � - -- � 1 ._i,�:_�'n �.1:��.:..1: . � � . Lll�1..� ,�. -� . r d <br />