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. . . � 'i.i.1'- ";y / <br /> . . - � . . ,•�:�. J <br /> BACKWATER PREV�NTIO,N;,4�VIC� PROGRAM <br /> ,�;,i.. <br /> Our records indicale fhat a hackwater prevenfion devicE musl be installed on the sewer <br /> connection at Ihe address identified on the enclosed letler Please help us veri(y Ihat our <br /> information is correct by ans�vering the following que_lions about your property: <br /> Do you have a basement? Yes 1�CI No ❑ <br /> �--� <br /> I(yes, does it have plumbing fixtures (sink, loilet, (loor drain, elc.)9 Ye. � No ❑ <br /> po you have a backwaler vatve on your sewer line? Yes � N�Don't Knova ❑ <br /> Do you have a grinder pump in your basemenl? �es ❑ No��on't Know ❑ <br /> Name: ���` �� ��(i{ -- --- <br /> ! <br /> Property address: .�_��d �� _���— <br /> Phone 1 _�v►���Q_�j I Phone 2: .___ -- --_ <br /> Ernail�. �/�J��Q� � C (�i.✓1� \ " ` ��v y v \' <br /> � �..... ''� .J,_l�V .d1��.�..:_ I_ . �,__�.�L. i'_�' . --�.�,i. ,.�!�`o='. <br />