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� �:x�� <br /> �... <br /> . . _ . . . . -� -.o... <br /> . . :,� � . <br /> � �BACKWATER.PREV,ENTION.D.EVICE PROGRAM <br /> Our records indicale that a backvaater prevention device must be inslalled on the sewer <br /> connection at the address identified on the enclosed letter. Pfease help us verify that our <br /> information is correct by answering the folloe�ing questions about your properly: <br /> Do you have a basemenl� Yes � No ❑ <br /> If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)� Yes ��No ❑ <br /> Do you have a backwater valve on y,our se•.ver line� Yes ❑ No ❑ Don't Knoti•� '�" <br /> Do you have a grinder pump in your basement7 Yes ❑ No'� Don't Kno�v ❑ <br /> Name: � �a.ryta/' ��I �Vi� . �( �. �•QO�(.��.r� �r�wN�' <br /> � /�L �80 y� <br /> property address ���__�/f�/t .1 I ��/ -�'`— � <br /> ' o/ y �..�.�k !' <br /> �one 1: liOG 8S 4 G}P f Phorie 2: T1—r � / �" 3j' � <br /> Emai�: _ G�.r� (�' Mh �✓��.'�/�!� Nl. �i0 � — <br /> W� � =. ��!'�,�.��.1��'��;;,�r;�'.�`�� , , � <br /> Z! .� t k��e:.i .t_ .t:��1:1i►:�^.R. <br />