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BACKWATER PREVENTION 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? Yext4 No ❑ <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 ❑ Don't Know)kl <br />Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Kno%v <br />Name: <br />Property address�t <br />Phone 1: 7CL- 42-T,kL� Phone 2 � -L �L 3� <br />Email: �cv^ti,`1Li1t�nJ�r-t_\¢"" tcrt�rlll—.Lt'YY \-- -- <br />•.(, r=' j <br />