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�---�_ _. - ---..-�- _ _ - ------- <br />. '1;�= . <br />BACKWA'fLR�PRF�iENTION DEVICE PROGRAM <br />Our records indicate�ihat 2 backv.�a�er prevenLon device must he installed o� your <br />;c-:vNr conneciion to comply v:ith the new ordinance Please help us verdy that our <br />�n'ormaUon is correct by ansv�enng the'�!lowiny ques�ions about your property <br />Do you have a basement? Yes �No [l <br />I` ;es, does it have plumbing (ixtures (sink, lode�t, floor drain, elc )� Yes [�tJo L; <br />Do you have a 6ackv.�ater valve on your sew2r line7 Yes �, �o ❑ Don'f Kno�v �� <br />Do you have a grinder pump in your b�sement� Yes ❑ No �Q Don't Knoce �� <br />Prcperty address <br />%�CUr <br />Phone 1�p��'�.�" ZD �-7- <br />�.�,; � �.,�.��!'l�l�,: �'L• , <br />