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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 abasement? Yes V� No ❑ <br />If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)? Yes 5 -No ❑ <br />Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br />Do you have grinder pump in your basement? Yes ❑ NoXIDon't Know ❑ <br />Name:�Ave <br />Property address: f // r' �'� <br />gZZ' 3 <br />Phonet: yZy -013� Phone2: 7Z� -jZ <br />Email: <br />