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BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicale that a baclnvater preve�rtion device must be installed on your <br />sewer connection to comply with the nea,r ordinance. Please help us verify tFiat our <br />information is correct by ansvdering the following queslions aboul your property: <br />Do you have a basement? Yes �No ❑ <br />If yes, does it haye plurr bing fixtures (sir,k, toilet, Floor drain, etc.)7 Yes� No ❑ <br />Do you have a backwater valve un your sewer line? Yes ❑ No ❑ Don't Kncw �j <br />Do you have a grinder pump in your basement? Yes � No ❑ Don't Kno�v � <br />w . / <br />Name: _ Vb�� VW N � • ��' • • <br />Property address � ' � �-���`�' � — <br />Phone 1: � 1 J' ��+ � � I I! Phone 2: <br />Email: • l �� v � 1� � �- <br />- � � — k f l,1 �.�. �;�, `�'f`�;����` � 'L�� t�f�j�t��l �1 ,!•1:!li�,. <br />� 1�7��1��i:5.t��.t1�1, �..•'•,cl:il �1L�Lil:�-�.ti�t'1i.1 aY.�E on <br />