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. . ' ' ..�.,� <br /> 1 <br /> �i ` . .,y:-„ <br /> , ,,A <br /> '�1�: <br /> BACKWATER PREVENTION DEIEICE PROGRAM <br /> Y+� <br /> :1'- '�"•I�j, <br /> . :. ^�;•,�. <br /> Our records indicale lhat a backwafei prevenlibn device musl he ins�alled on your <br /> sewer connection ln comply with Ihe new ordinance. Please help us verity that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement7 Yes �No I� <br /> If yes,does it have plumbing fixlures(sink, toilet, floor drain, eic.)? Yes� No ❑ <br /> Do ou have a backwater valve on our sewer line7 Yes � <br /> y y ❑ No �] Don't Know [�, <br /> Do you t ave a grinder pump in your basement? Yes ❑ No L] Don't Know�iQ <br /> NamP: L�P�`V� ��/�-- --- <br /> PropPrty address: � ���(/�l U�. ___ <br /> Phone 1: �.�i.� r�5 J� ���hane 2: <br /> Email: _� �� 1J�1.�� �1�-1�U'.1 a S._-��� - ---- <br /> ^,.<i v ^' :,; �, � `.::��•F' , i � + ; ; <br /> ii � . <br /> �..,�, - �.$�';t�'• _.. _., ,... 'c_�._ . . _.�i.i:..__ , ..._ �.—__,.. ' <br /> - -- , <br />