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. �� . - J <br />BACKWATER PREVENTION�UEVICE •PROGRAM <br />Our records indicate 4hat a backwater prevention device must be installed on your <br />sewer cqt)nection to comply'with the'new ordinance, :Please lielp us verify that our <br />information is correct by answering fHe�following t�uestions about your propeAy: <br />Do you have a basement % ti'as I�No ❑ <br />�� <br />If yes, does it have plumbing fixtures (sink toilet, loor drai � etr,.�? Yes No ❑ <br />Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Kno�a � <br />Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know� <br />Name: G � � � � T <br />�I_�P� -� �� / �� ��` � �l%, �� � <br />Property address: [ <br />} Phone 1: 2� �� ��0� _ Phone 2: <br />Email� �G11�Q� S�/.� U` �Y It.��'�GC� ✓j'jGl t�� �'.� � <br />i � <br />Y�r..Jd%�,tii:� 1 � +�� . � . . r_�Li:�t, <br />