Laserfiche WebLink
� <br /> , <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevenlion device must be mstailed on the sev;er <br /> ' connection al the address�idenlified on Ihe enclosed letter. Please help us verity that our <br /> in(ormalion is correct by answering the follo�•�ing questions about your property: <br /> Do you have a basemenl7 Ye �o ❑ <br /> If yes, does it have plumbing fxlures (sink, toilet, iloor drain, etc.)? Yes [v��No ❑ <br /> Do you have a backwater valve on your sev+er line? Yes ❑ No � Don't Know [J� <br /> Do you have a grinder pump in your basementl•Yes � No � Don't Know �� <br /> Name: (. aY� � L . <br /> a Properiy address:. S✓�/3 � �aB Z C'-�'(�c.�leL�� <br /> : �/ <br /> Phone-1: Y'�S�.u� -3'fO �P P.hone 2: T-7i.�-- �� :/ '- �2-Q' <br /> EmaiL O�l �C V1 U�-JC � �-�/GL`zW � �'Yl <br /> - i i + , ��i.t:• � � • <br /> . ._ . ._. .r�_..-.� :l��ll:l���,��'!lIi�1S]-al�il��r'Ir4•1�I�Ir� ,��`iD•�."��}'�•�'i!},��1�1�� m� <br />