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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance.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 In No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Ie 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: RO be."' t- WA,* '" GOA 5 tri <br /> Property address: /7 4,tie fri`q'\. AVe. <br /> Phone 1: S!/;7-ZS2'9196 Phone 2: 26' (9 9 y <br /> Email: 600/1 ,9 0 (rove. COM <br /> ,t . _. ' <br />