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BACKWATER PREVENTION DEVICE PROGRAM <br />our records indicate that a backwater prevention device must be installed an 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 X No ❑ <br />If yes, does it have plumbing fixtures (sink. -toilet, floor drain, etc.)? Yes ❑ No X <br />Do you have a backwater valve on your sewer line? Yes ❑ No L% Don t Know ❑ <br />Do you have as grinder <br />pypump in your basemen:? Yes ❑ ❑ <br />I No R Don't Know <br />Name: _O ii V w <br />Property address 3 J_Ol_O. <br />1404 <br />Phone 1 _{ �S 6�iP�1 Phone 2 _ <br />Email _Jai/ k..4i7—&1 �41114 SZl - — — <br />__ .._..,,.r. _--- + �i�ikif�l.l,ildill'ttn:r.'r` rr �� i;++1�1•-�'+'tttlli �1ll�tlrfl.`il'il l!j;�iltLl�.�rl, <br />