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BACKWATER PREVENTION DEVICE PROGRAM � <br />Our records indicate that a backwaier prevention device must be i�islalled on your <br />se��er connection to comply wiih the new ordinance. Please heip us veri(y that our <br />information is correct by answering the following questions about your pruperty: <br />Do you have a basement7 Yes [� No ❑ <br />If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)? Yes � No � <br />Do �ou have a backwater valve on your sewer line? Yes ❑ No � Don't K�ow � <br />Do you have a grinder pump in your basement? Yes ❑ No � Don't Know ❑ <br />Name: �AI�VPI�� K��NE <br />Propertyaddress: 20�0 v/RG/N'/A AVE _ <br />I , t� <br />}�Phone 1: 7 Z� �sq' 39 3° . Phone �' <br />��'�. `• <br />�: s,�;,i'l:�i�;kc <br />