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xr I <br /> ,.. , ,,... <br /> BACKWATER PREVENTrtl DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes No III <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No w <br /> /❑ Don't Kno <br /> Do you have a grinder pump in your basement? Yes ❑ No �"Don't Know ❑ <br /> Name: LalAr1< 1"e C1 f"Y\ 5€ <br /> Property address: cQq0D., Cec$ c <br /> Phone 1: LOS Q,SS e 3. . Phone 2: <br /> Email: <br /> : Est <br />