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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicale that a backwater prevention device must be installed on your <br /> sewer conneclion to comply wilh the new ordinance. Please help us verify that our <br /> information is correct by ans�vering the following queslions about your property: <br /> Do you have a basemenl? Yes � No ❑ <br /> If yes, does ii have plumbing fixWres (sink, toilet, Floor drai . elc.)7 Yes � No Lj <br /> Do you have a backwater valve on your sewer line? Yes [ No � Don't Knov� [� <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know � <br /> Name: _�y��HG�S <br /> Propertyaddress. y�Z-�i 7�''t�r1'�('e QY� t�leY��'�' C7��j <br /> Phone 1: .�i(s�' riU�1-_i�4'fif Phone 2: <br /> Email: . ��I�D1 ��hn+mr �l C <br /> :` ' -'-'r.�. <br /> , . , � , <br /> 11 � ' „ i <br /> .�_�]_._��_� .. _�i.4 s_ -.� . �� •_.�._�.. .. . ._. . ._ . _. . . .. •.� � . ... <br /> i' <br />