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BACKWATER PREVENTION DEVICE PROGRAM <br />'our records indicate that a backwater prevention device must he installedbn your <br />sewer connection to comply with the new ordinance Please ho'p us verify that our <br />information is correct by answering the following questions about your property: <br />Do you have a basement? Yes •�o I] <br />If yes, does it have plumbing fixtures (sink, toilet; floor drain, -etc.)? Yes QAo ❑ <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 ❑ Don't Know <br />Name d V -a A -1 C—_�!— S <br />Property address: <br />Phone 1: 4-� 2 14 Phone 2 <br />