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, - - <br /> . , • . _ , ,;'�. l+l" <br /> - � :::_, ,. . <br /> .�' BAGKWATER PREVENTION D.EVICE PROGRAM <br /> . . . . .- ;, <br /> Our records mdicale tha� a back�:�ater prevention oevice must be insialled on your <br /> sevier conneclion to comply wdh Ihe.netv ordinance Please helpLs venty tha; our <br /> . information is correcl by answering Ihe follo�ving queslions about your FiropeAy <br /> Do you have a basement? Yes�No ❑ <br /> If yes, does it have plumbing f�xtures (sink, toiiet,lloor drain, etc )? Yes�No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No�Don't Y.no�v ❑ I <br /> Do ycu have a grinder pump in your basemenl? Yes ❑ No�Don't Kno�v � <br /> Name .���_�_C--�/�� -- — <br /> Property address. _�����--� �-� l�" p , <br /> Phone 1 [ � ✓r���' ���2 <br /> Email [��'��-f!— ����— C`-- —�r�/1/ . C�n7 i <br /> - , ,�, 4�l , . .f. I �4! . ... <br /> ---- ,__ .� �1�1�1��J;�J�J,i�lt�l.i�'i�i�dral��� t9�+����tl,�;r�=ti:;?x.l��: �� I <br />