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� . <br /> '.- .,',� . ' � ''•si{ . / <br /> �-� !J�BAACKWATER PREVENTION DEVICE PROGRAM � <br /> `A � r. L�-'r' <br /> Our records indicale that a backvdaler preven!ion device must be inslallsd on the sewer <br /> conneclion at the address identified on the enclosed letter. Please help us venfy lhat our <br /> informalion is correcl by answering the following questions aboul your property: <br /> Do you have a basement� Yes � No ❑ <br /> If yes, does it have plumbing fixlures (sink, toilel, floor drain, etc.)7 Yes ❑ No ❑ <br /> Do you have a eacY.waier valve on your sewer line? Yes ❑ No ❑ Don't Knotv� <br /> , . Do you have a grinder pump in your basement? Yes ❑ No �Don't Know ❑ <br /> 's:;. f <br /> � Name: ��A�.1 U�SU✓� <br /> Property address: �� �I ✓lY ���(' <br /> � Phone 1: �JG� y�I� 7I a� Phone 2: � <br /> Email: le j)I���I�✓� _ <br /> — , � . . . ,�.,Y;,��}���rt'�i�;l'.�'�:[�r;;..:,,:--,1� <br /> --�,`� ---�---�r ;.ln.�;J��..;��kli�;���i+, tti.!'I�,.iiilf�:�"L`�.i L,�}`��I�LP.Iil.ei�fJ�O� <br />