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BACKWATER PREVENTION DEVICE PROGRAM l <br />Our records indicate that a backwater prevention d6v' Ice must be installed on the sewer <br />connection at the address identified on the enclosed letter. Please help us verify that our <br />information rs correct by answering the following questions about your property: <br />Do you have a basement? Yes ZNo ❑ <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 ❑ No V Don't Know ❑ <br />Do you have a grinder pump in your basement? Yes ❑ No [Don't Know ❑ <br />Name: � 0 /- ' /sin r 1 C.rd it CA <br />Propel If address/U U / t/! IAYi/I Ii 1 ' T � e' r� <br />Phone 1l(2hi ) �GfEj� � lJ7 � Phone 2: C�7iJ 1 ���1/ � 762— <br />Email: MI$SL7bL G LQ rA 174T <br />, <br />