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/ <br />BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicate ihat a back«�ater prevention device must be installed on the se%er <br />connection at the address identified on the enciosed lelter. Please hNp us verity that cur <br />iMormation is correcl by answering the follo�ving questions about your property <br />\ <br />Do you have a basement? Yes [� No ❑ <br />/� <br />If yes, daes it have plumbing fi�(tures (sink, toitet, tloor drz�n, etc.)? Yes � No [ <br />�o you have a backaater valve on your sewer hne9 Yes ❑ No ❑ Don't :Cnc�.v� <br />Do you have a grinder pump in your�asem� t? Yes ❑ No ❑ Don t Knotiv � <br />. <br />Name: �/�_Cir�� /�� � 11 1� <br />Property address: 5��1 �W � ' <br />Phonel:�Q�,,��_D�— P�ione2: <br />Email: <br />V�� _ <br />, w� °I�o3 � <br />! i.l.eJ _J �: L•. . .. .'1� � Y,IWIM• ._ . . . . .� ... �. <br />