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� <br /> � <br /> BACKWATER PREVENTION DEVI�E PROGRAI►� <br /> Our�ecorcis indicate that a backwater prevention device must be instaL'ed an your <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> intormalion is cor�er.t by answering the iollowing questions about your properiy: <br /> Do you have a baoemenl7 Yes �-No ❑ <br /> If yes, does it hav� plumbing fixtures (sin!;, toilet, floor drain, etc.)? Yes �No ❑ <br /> Do you have a backvdater valve on your sewer line? Yes ❑ No ❑ Don't Know � <br /> Do you have a grinder pump in youi basement? Yes ❑ No �L`c,:t Know ❑ <br /> Name �q�/LSo'�1 <br /> Properly address: _ ` ���' ��bR� ._ <br /> � Phane 1: ��-s Z�9 S��P Phone 2: �Z? SDS ��"� <br /> r <br /> Ert�ail: fi�lo�\L-'..[�R�1 S a r�� G h'1W.-� `.C-t*�'� I <br /> , . .�,111c �Iri , <br /> ;a,�,ir�+�..l;�l,�;f.:: +: � ; �.�,ii . �. ;.�;�.::,�- � :,: ,.:.. ` . <br /> � 1 . <br /> – - — - --- / <br /> � <br />