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BACKWATER PREVENTION DEVICE PROGRAM /, <br />Our records mdicate that a backv�ater prevention dewce must be installed on your <br />se�ver connection to comply w�th the new ordinance Please help us ��enty that ou� <br />,r.'ormalion is correcl by answenng the following questions about your properiy <br />Do you have a basement� Yes � No ❑ <br />!`. yes, does it have plumbing (�xtures (sink, toilet, floor dra�n, etc)� Yes �7!�No � <br />/ `-, <br />Do you have a backv:ater valve on your sec�er line� Yes ❑ No f�] Don'; Know y <br />TT <br />Do you have a g�inder pump in your basement? Yes ❑ No � Don't Know ❑ <br />Name ��(.L.LEt�—D•� ��'�- <br />P;opertyaddiess ql9 G�ANd__ �� �V j___���0/ <br />Phone 1 a�� q�±Q�l j S _ Phone 2-_- --- <br />E�».��i _�c�l . OG� P U Q_Cdtn����� — <br />. <br />.' "�t� I •� <br />ldi,�.1.�.'_L: �.� .�:�'�lI�IL�'f"�.. .. .1.:.�i....4 � ■ <br />