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BACKWATER PREVENTION DEVICE PROGRANI <br /> Our records indicale that a backwater prevention device must be ins�alled on your <br /> sewer connection to comply �vith the new ordmance. Please help us verify lhat our <br /> information is correct by ansevering lhe foilowing questions about your property: <br /> Do you have a basement? Yes � No ❑ <br /> If yes, does it have plumbing fiutures (sink, toilet, floor drain, etc.)? Yes� No ❑ <br /> Do you have a back�vater valve on your sewer line? Yes ❑ No ❑ Do-�'t Know (�,' <br /> �- <br /> Do you have a grinder pump in your basement? Yes ❑ No j� Don'I Know ❑ <br /> 0 ' <br /> Name: I�'e`2i'� J G�(.��Sb Y� <br /> Properiy address: ��3 v���� ��f�, .�c 1 1 l�LV I <br /> Phone ���0 �p ��_�'� hone 2: � Z�=��� "I Z.�t <br /> d��h�e►- �°t�n�: i`�tar�z 4-F�,S�. <br /> Email: L-.Q��Q�i1 <br /> < < ''i{'�i�� � f �.t.�:,, i. <br /> w�.�.._. _� :1.,�_��i��J9s�!+.1:. .J.1,��`��..1���L:�.__ �.��z�:1,._.�. . <br />