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_ _ _ _ ✓ <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our,recbrds indicate thal a backwaler prevention device must be installed on your <br /> sewer connection to comply with lhe new ordinance. Please help us verify thal our <br /> � . in(ormalion is correct by ansvaering Ihe following questions about your properiy: <br /> � Do you,have.a.basement7 Yes No ❑ <br /> �Ifyes, does il have plumbing SxWres (�12, t�Jt floor drain, eic.)? Yes �No ❑ <br /> Do you have a backwaler 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: / 1�v.�7�L—P� <br /> PropeAy address: 1l��7--�iQ ��G� � . <br /> � Phone 1:���� i7 S L -��Ji� Phone 2: SU�'>'� '�—'J _ <br /> Emaii: I�QI'Jp/ _ -- — <br /> — , , i�. -- , <br /> � <br /> __ , ,� �� , � � � <br /> -� ��_ _ . . �_._ �_ ��_�A L.:.;.�� .�.. i. .._�.�_ -..._Y .. �.._J . .._ _�_ <br /> � <br />