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. ;''�' .. <br />BACKWATEFc PREVENTION DEVICE PROGRAM <br />, <br />Our recoeds indicate lhat a batk�:ater prevenUon dev�ce must be instab.ec o•� yn�,n <br />se�ver connection ta �omply with the new ord�n,3nce PIe.3se help us verdy R�at ou� <br />information is correCt by anse�enng the tollo::.r�� nuusb�ms abou: y^�• urepert; <br />Do you have a basement� Yesx No ❑ <br />C—' _ <br />If yes, does �t have plumbing 4xWres (sink, to��et. �ioor drain etc �^ Yc-s�Nc� i <br />Do you have a backwater valve on your se�ver line� Yes C No �Don'1 Knoe: ,_ . <br />Do you have a gnnder pump in your basement� Yes i I No�Don't Knov� ❑ <br />Na.,� �, ����- �- w��; �p — — — <br />P�operty address ��_ ! _ � `�G r'� �__ ��/� _ __. <br />Fhone t�1'�OJ�-(Y�(>5 _ pnone 2 CIUI�/�%��D ��JV / <br />Email ���.W{i.�.( ��Nl�'�� y1C-_l�' — – — <br />; -- - ----- i �� }.fi�1iZ,i��+r' ���(��I�I�°I� • <br />-t-- _ '- 1 ��,?:�i�]_d �IJ�4�,��;.a1:s ,"`:ti:'��'7i:lfti'':�'��:;�. ^'.:.+ii::i�:ii�r N,�� <br />