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,�8�7 ,�d�T �}v�u;- <br />BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicale thal a Lachw&ter prevention device must br installed on the se�•rer <br />r.onnecUon at the address idenli(ied on the enclosed letter Please help us verify ihal our <br />informa�ion is correU by anstivering lhe folloeving questions ab�oul your properly. <br />Do you have a basement? Yes � No ❑ <br />If yes,'does it have plumLin� fixlures (sink, toilet, floor drain, etc )� Yes �� No L <br />Do you have a backwater balve on your sewer hne7 Yes ❑ No �, Don'I Know �_; <br />Do you have a grinder pump in your oasement7 Yes ❑ No � Don't Know [] <br />Name -���}�L�.1 � � •-t� . v�+ � ��_ - . � . I <br />.i'L� t 1� TG�• <br />p�r--� � ��1 ioC--�YS�`�''u� I, <br />Property address _�__��_ /— - --� �- - - � 'lcc�r�--t!� �ca ��-��-�;/ <br />I'honel�. T�:��vZc%D �,7_�l'� Phone2� 3�—��`�_�'��_`E'�H) � <br />Finad c�����r_�f�.���'15'h. cc�M_ ____ ._ <br />---__ -- . ���;���}�;�:,�t-.ti7���)i►i�i�����. . . <br />- . - T'-`.-.�:F�lf!�:.r`•��.�.�t�.11�:�ii?��.�L�L'l�:}�a\�!!.]:Li�L:..�i.l�'_•nt"��:i:{�.�.3�i� <br />