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. . :.°.� <br />' . . . t;,..:, _ ;,wc+ <br />BACKWATEft�REVENTION DEVICE PROGRAM <br />Our records indicate tt�at a backrrater prevention device must be installed on your <br />se�.ver conneclion to comply with the new ordinance Please help us verify lhat our <br />information is correct by ansvaering the foilowing questions about your property <br />,. <br />Do you have a basement? Yes_•[� No ❑ <br />I( yes, does it have plumbing fixtures (sink, toilet, Ooor drain, etc.)? Yes�No ❑ <br />Do you have a backwater valve on your sewer line7 Yes ❑ No'❑ Don't Knova� <br />Do you have a grinder pump in your basement? Yes ❑ No Q Don'1 Know� <br />...._ �-.5�, �-+ s <br />Name �_ ��l���L <br />PropeAy address: �� � i �' r��"/r 4-� ��v i� — <br />Phone 1 �Z�Ij'1'_Vil,� Phone 2: �j'.– - ��I � -�'�3 <br />Email ' � <br />•. ,� ��` '��:, I�;,� < ��.,. . . . ,: '. <br />:G���l�k1��:.,i�r��: ;,� J��:��. !4 _t_�!:�. ��':�,t ,: <br />