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:,..., , <br /> ;:, „ ._. . <br /> :.i...< <br /> '.-�� . � <br /> ��'�..,: BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate ihat a backwater prevenlion device must be inslalled on your <br /> sewer connection to comply�vith ihe new ordinance:Please help us ven`y that o�r <br /> in(ormation is correct by answ�ering the following queslions about your property: <br /> Do you have a basement? Yes [� No ❑ <br /> If yes, does it have plumb�ng fixWres (sink, toilet, floor drain, etc.)? Yes � No ❑ <br /> Do you have a backv�ater valve on your sewer line? Yes ❑ No ❑ Don't Know � <br /> Do you have a grinder pump in yoiu basement? Yes U No � Don't Know ❑ <br /> Name: ) � G V V�A) I � J/`�Dc'l�£� <br /> Property address: 1� �l _� (�Fi ��i-4- �-�- �� / �v ` <br /> Phone 1:'Y�S- �5��'- / �l�� Phone 2: '�/z-S � 3 �' r)_iT� �' <br /> Entail: _�L10 �f I -�j 60 1..._ Cc'7'Yl9 �-° /�'$�i • /'� Ci <br /> .� , • •i;+• �:.�. <br /> � <br /> . . ' �: I � , • -- _ —i_ ._ .L' ' <br /> —�--- ___. _ —� _.. . .__ :i _ . _ . . __. <br /> -I <br />