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- ---- -- .�-.�,-: - - <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwa'er prevention device must be installyd on your <br /> sewer connection to comply wilh the nev+ordinance. Piease help us verify lhat our <br /> information is correct by ansv:ering the following questions aboul your property: <br /> Do you have a basemenl? Yes �( No ❑ <br /> If yes, does it have piumbing fixtures (sink, toilel, (loor 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 basemenl? Yes ❑ No � Don't Know �� nr�pc,y 1.� <br /> /' No`.� <br /> Name: �� COW1b�1_� ��'1..) `jHc1� G1^�� y <br /> n ✓ <br /> Property address: O� � a y ��c��G ��P►1 e/ _ <br /> � Phor�e 1: � a� �h � ��U a C Phone 2: 0`1 G G ��� ��1�, <br /> --- -- -- 5 <br /> Email: SJZ•GSvL�.� ���Jr�e�'1Pid � r�c� <br /> �— � .' ' . tl( ..�r:.+ �:;1 :'i . . . <br /> � i � . t <br /> r�... � l �� �I'� ..� � <br /> _ __�L__ �"_ _'_`__ '" "'_'� .�.� ,...'L. .. _..._, . _. .. .i . . . . . .... .,_ <br /> I <br />