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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 y,tilo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? YesNo ❑ <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: 75 k-. <br /> Property address: -T-(2 7. iy 'L e <br /> Phone 1: yuS 3`21J';)3 �/— Phone 2: <br /> Email: <br /> g <br /> : Gas >,_ <br />