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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. 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 NiNo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes [V"No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know V[r <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know L1/' <br /> Name: iCe N''# & <br /> Property address: t%17 /4GtFtc <br /> Phone 1: YZS" 'f -7 73s Phone jj2: <br /> 3O IIL <br /> Email: �t de '✓�. .' G � D • Cat <br /> 17 n TV4 .;371i H' its r, <br />