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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate thal a backwaler prevenlion device musl be installed on your <br /> sewer connecUon lo comply with the new ordinance. Please help us varify that our <br /> informalion is correct by answering the following questions aLout your property: <br /> Do you have a basement? Yes � No ❑ <br /> If yes, does it have plumbing fixlures (sink, loilet, (loor drain,elc.)7 Yes � No ❑ <br /> Do you have a backwater vatve on your sewer line7 Yes ❑ No ❑ Don't Know-� <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know � <br /> Name ++�r1 �"y�i�G� l <br /> Property address: lbb �Q���_f Ev �Q//�6' <br /> � Phone 1: ?��� L b � s(� Phone 2: �_�is� ��b" �� <br /> Emad: �� �f ��.�% V��K^Gi� .(�'O"r1 --- <br /> � '•'4�1 �C(1c— <br /> ,� � <br /> „ • . . �. � <br /> .:i,:ycy,� ,�d_:i!i� _l � �...��r* .IL:: . .. !,_� Z''. .._ ti4 . <br /> ,\ <br />