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1 1 <br /> L 'Mu <br /> BACKWATER PREVENTio4DEVICE 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 ftl.No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes I No <br /> ;rs <br /> Do you have a backwater valve on your sewer line? Yes ❑ No X Don't Know d"":x ,;' <br /> Do you have a grinder pump in your basement? Yes ❑ No' Don't Know ❑ <br /> Name: ;"' A' C e% 14 <br /> Property address: 3 3 o "� ..I 0 C f' -e 'e !('Qo_ A�V <br /> L ✓"2(2e Tt ‘A-0VN- e 7 0 <br /> Phone 1: I-D 5- 50 }. `l`-/5' Phone 2: <br /> Email: b r 0 AK d al o 5 f"0/2vC3 cotAA 41 rJ''i ` iv `f <br /> .�.1 • � y. <br />