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. ... .._ .. <br />BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicate thal a backwater prevention device musl be installed on your <br />sewer connection to comply with the new ordinance. P�ease help us verify lhat our <br />information is correct by answering the fofiowing questions about your propeAy: <br />Do you have a basement? Yes�No ❑ � <br />If yes, does it have plumbing fixtures (sink, loilet, iloor drain, elc.)? Yes�No ❑ <br />r-�� <br />Do you have a backwater valve on your sewer line? Yes � No � Dn:i t Know <br />Do you have a grinder pump in your basement? Yes ❑ No 0 Do,i t Know <br />Name: J(�A ��nAi C �11�5»C—V2V2.�-/ <br />Propertyaddress: ��Z� ��`����� AVC <br />} Phone 1� Cy2S� ZS�; -3y8� Phone 2: SCG- ��-10vV C� i <br />Email�. � /,�aOVC�n cdo>vX�sC' a- C�-�T �' ��� �STZA�'1D <br />���ti:(�:ir�� ( <br />. 1'+ <br />�' J <br />!�1 7 <br />0 '� <br />V� � <br />U � <br />L1 � <br />oN � � <br />�� <br />i <br />f, �u_,�4�}}.�:�. <br />