Laserfiche WebLink
BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate thal a backwaler prevenlion device must be instalied on your <br /> sewer connecUon to comply wlth the new o�dinance PIBdSE F1P.I(7 US VP.f1Iy ff12� OLl! <br /> intormation is correct by answerng the lollowing quesbons about your property <br /> Do you have a basemenl� Yes yT� No (� <br /> If yes, does ��t have plumbmg fixtu�es (sink, loilet, Iloor d!ain, etc )� Yes � No ;J <br /> Do you havr: a backwa!er valvc on your sewer Imr.'� Yes ; .j No ❑ Don't Know �{ <br /> Do you havc a grmder pump in your basemenl� Ye; ❑ No �7J Don t Know ;] <br /> Name 1.r11/��l D �XO✓1 -- --- _ <br /> Property adJress � � �S C��a r S'�� _- <br /> F� F'hone 1� _l�_7.S— 7 70=��G � F'hone 7 <br /> I <br /> Emad _ _ — — ---- --- -- — — <br /> I`l--, � 1 ����'+�,���,`1•' �! ���� �� y , ' <br /> "'""'"""'��7;►��1���i+,,�pk���.l�l,l-i��t�L�l�'�;S 1�:��1�:ut.l��,k,k� <br />