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. — / <br /> ✓ <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicale ihat a backe�ater prevention device must 6e installed on your <br /> sewer connection to comply�vilh ihe ne�v ordinancc. Please help us verify thal our <br /> mformalion is correct by answeriny ihe (ailowiny queslions about your property <br /> Do you have a basernent? Yes �j No ❑ <br /> If yes, does it have plumbing fixtures(sink, toilel, floor drain, etc.)? Ycs � No ❑ <br /> Uo you have a backwater valve on your sewer Ime7 Yes ❑ No �j Don'l 1<now ❑ <br /> Do you have a grinder pump in your basemenl7 Yes �f No � DonY Kno�v �J <br /> Name: TgO.[_Y ���-��1 __ <br /> Property address I3?jZ Q.\iL1L�Q- /��E ___ <br /> Phonc 1 4�Fa ��_�J'�''4b _ Phone 2 ____ <br /> r_�»a�e _ TC,�tj�r� e F�o�aT'�. -C+cSr_1._ — <br /> . _ .. - _�_...—�_ ���iC <br /> ,;," <br /> • ; <br />