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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? YesNoha <br /> ❑ <br /> If yes,does it have plumbing fixtures s toilet,floor drain,etc.)? Yes' No ❑ tau ( <br /> ink o <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 N, , Lf1T <br /> Name: G $ v 1. ��� <br /> Property address: 9 \ %, �'.L<JCJA/ <br /> Phone 1: ` ✓' ,/'' 7- PR6ne 2: <br /> 4 <br /> Email: �' . L # /�:&I- 4k,' l i 40.1.�_ <br />