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� <br /> BACKWATER�PREYENTIO.N DEVICE PRdGRAM <br /> :, , <br /> Our records indicate that a backwale�prevention device musl be installed on your ' <br /> sewer connection to comply with (he new ordinance. Please help us verify that our <br /> m(ormation is correct by answering the following questions aboul your property: <br /> Do you have a basement? Yes � No ❑ <br /> I(yes, does it have plumbing fixtures (sink, toilet, floor drain, elc.)? Yes � No � <br /> Do you have a backwaler valve on your sewer line� Yes ❑ No � Don't Know ❑ <br /> Do you have a grinder pump in your basement9 Yes ❑ No ❑ Don't Know� <br /> Name: � \�� 'V`�� ��'�W�\� <br /> Property address' ��l____����i�S � ` �� <br /> Phone 1:��� .�� Phone 2: `'t"� ��I _" � /�� <br /> � <br /> Finail:�� _ _���1y_v_L���.1�v�ti' — <br /> 1 ` 4.J <br /> . , ., ,4�,�:. .i , ��,��� ; . <br /> : � , <br /> �� � � — - � :��,,�.i_�i�,�a t�4�!��>>.�_ ,�:��;�.!�,���,s���:,,�., _ �����.�,:�� <br />