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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/No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yesie No ❑ <br /> Do you have a backwater valve on your sewer line? Yes2rNo ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No Wf Don't Know ❑ <br /> Name: Y <br /> Property address: 14 a 7 g 04k ael 4P-'11". 14 Ye" <br /> Phone 1: 4 Z S.Z 31. 01$3 Phone 2: <br /> Email: 4ea I t' ri t� Y"1 s <br />