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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 �1 No ❑ <br />If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)'? Yes t�,No ❑ <br />Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know I 1 <br />Do you have a grinder pump in your basement? Yes ❑ No9f-Don't Know ❑ <br />Name: ��� CD �� I �79 � �f <br />Property address: �S am/ /tr r�r�'^ l ' 2 ' <br />Phone 1:4 K - 2 c;-� C7 � T 6_ Phone2: ?S-3 ZG-/ <br />EmailCQ: 1 �� ( <br />� - ■:a�i+�dit�.��r�.'�uli!L��� i�1�1��';I�!'d�1iiG3�����_;_:�,rLH>!,�;tl.���° ! I <br />