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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? Yes g( No ❑ <br /> If yes, does it have plumbing fixtures(sink,toilet,floor drain, etc.)? Yes ik No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No A Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No x Don't Know ill <br /> Name: 1)1416 05.5 <br /> Property address: O r [ 1,0„.."`-4_ e__- GV fie'"`/ l ?2`-'1 <br /> Phone1e: 2-572, --5A6d Phone2: / <br /> Email: G �L •v �2 a-��o�JL 4VAa , t • 'Cr,' - <br /> V <br />