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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 follovring questions about your property: <br />Do you have a basement? Yes K No ❑ <br />If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)? Yes iL No ❑ <br />Do you have a backwater valve an your sewer line? Yes ❑ No ❑ Don't Know <br />Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br />Name: k be- . /-, � /< I, <br />Property address: 3/✓e ��'rP�% �✓��"" / <br />Phone 1:flW/ ? ae J,,(75 �/, Phone 2: <br />Email: <br />