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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance.Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes g No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes X No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br /> Do you have a grinder pump in your basement? Yes ❑ No ElDon't Know <br /> _„„ Name: Pam! am.of,, �°y'ir t 'Se ri Ina v,afi <br /> Property address: 1.0 00L {_5 U G �IL� �°% ` � � <br /> Phone 1: 4 z*s--2>>Cam'O I Phone 2: <br /> Email: OYY\c9 COM(aS-/ -ref <br /> _a rt <br /> .,�p.,fi 4 .�. . ......_ te ..,a., ..,,. .. �i6*, ' _ t.1111 <br />