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BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicete that a backwater prevention device must be installed on your <br />sewer connection to compiy with the new ordinance. Please heip us varify that our <br />information is correct by answering lhe following questions about your propeAy: <br />Do you have a basement? Yes �j No ❑ <br />If yes, daes it have plumbing fixtures (sinl<, toilel, Ooor drain, etc.)? Yes�j No ❑ <br />Do you have a backwater valve an your sewer line7 Yes ❑ No � Don't Know ❑ <br />Do you have a grinder pump in your basement? Yes ❑ No � Don't Know ❑ <br />r <br />Name: <br />PropeAy address: ,�� n f O�6y /f`� <br />Email: <br />.. . _ - _ -�_--�-'� =.��' i <br />Phone 2: <br />� 'i • � .�'�^�1 <br />�� J�'1��,.1. ��v'. {'; ,;u ���� � <br />�. �. .. .. .. <br />