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.. . ' . ' .�i. . <br /> .��.,. , <br /> , _BACKWATER PREVENTIOt�;�SEVICE PROGRAM <br /> � <br /> , > : <br /> � Our records�ndicaee that a backwaler prr�yention device must be inslalled on your <br /> seerer connection lo comply�vdh the ne,i ordinance Please help us venfy Iha' our <br /> �nformation is corrett by answering the following queshons aboul your property. <br /> Dn you have a basement7 Yes X No � ; <br /> If yes, does it have piumbing fixtures (sink, todet, floor drain, etc.)? Yes �( No �J <br /> Do you have a backwater valve on your sewer line� Yes ❑ No � Don'1 Knov� �I <br /> Do you have a nrindcr pump in your basement� Yes ❑ No R Don't Knov+ �1 <br /> Name — �✓AN_ �.�/{Y G/4R(t'ETr — —. _ _ <br /> PropeAy address Z�O� /�UG'�E�C _�✓EfUL'E - <br /> Pi�one � �IZS�-33y-ZZ3I_ Phone2 �lZS-3oFr- �06'6� <br /> Email E'Sa.rr-e7-t�lZ @ co�hcrst. nc�t <br /> ��— - — <br /> , , !i'�, �i� �� I , <br /> _. _.__ � - - ,- . ,I, � � , � <br /> `— — .,�:�,��:il:L4_�._.. �__�'..'.'y��.'.!I!'� ; . �.:�t.c�.1 ,. �.,L• C: <br />