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f <br /> BACKWATER PR�VENTION DEVICE PROGRAM <br /> Our records indicale that a backwater prevention device must be mstalled on your <br /> sewer connection to comply vnth the new ordmance Please help us venfy that our <br /> information is correct by answenng the following questions about your property <br /> Do you have a basemenl7 Yes�No ❑ <br /> If yes, does il have plumbing fixtures (sink, todet, iloor drain, etc.)7 Yes �No U <br /> Do you have a backwaler valve on your sewer line� Yes [� No �Don't Know � j <br /> Do you have a grinder pump in your basement? Yes ( � No � Don't Know �_� <br /> Name �ahl � 1.___.��G��UPO�_ . __ <br /> Property address. z� � �–� ` Q-r �! ' _ _ __..__ <br /> ' i Phonel y2s-3�7_oi 96 phone2 ?.cJb _F�BJ=y�o,�9 <br /> [mail �11 0�S NCAC� cs y�t l�Ua• �_UlM _ __ <br /> — --7 <br /> - ,7 <br /> --_. ---i�-j i' �i� ` , <br /> :..��!.�a.��.l.y ��:.�1i ., � ._n�-.-- i. �1..._�i_ ..1 � <br />