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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 Ig No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes No ❑ <br /> Do you have a backwater valve on your sewer line? Yes III No X.Don't Know III <br /> Do you have a grinder pump in your basemea-,nt? Yes- LI No)KDon't Know ❑ <br /> Name: Nilo, <br /> it) "C�1 <br /> Property address: a6 C/ lvl- 44i'U <br /> Phone 1: f ,��} Q�13`?glic Phone 2: <br /> d <br /> Email: A i ? tf/�'/x1 I11Lih ©M <br /> ��� ter , ,: , , , <br />