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� T Cc;�n+�o�- �ay ��o,� �� s du=�- o�` �s�-et- <br />BACKWATER PREVENTION DEVICE PROrRAM �: �Q-►'1 <br />� v�'l�ur „/ <br />Our records indicate that a backwater prevention device must be installed on your <br />sewer conneclion to comply with the new ordinance. Please help us ve�ify that our <br />information is correcl by answering the following quesfions about your propetiy: <br />Do you have a basement? 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 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: <br />Prope ; <br />h Pho�e 1: �V �S��J �.710�! Phone 2: �%iS c�� ���Q <br />Email: <br />