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BACKWATER PREVENTION DEVICE PROGRAM <br />Our rewrds indicate ihat a backwater prevenlion device must be installed on your <br />sewer connection to comply wilh lhe new ordinance. Please help us verify ;hat our <br />mformalion is correct by answering the follcwing questions about your property: <br />Do you have a basemenl7 Yes �No ❑ <br />I( yes, does il have plumbing fixtures (sink, toilet, floor drain, elc.)? Yes [� No ❑ <br />Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know � <br />Do you have a grinder p�mp m your basement? Yes ❑ No �J Don't Know ❑ <br />Name: I%-%l( h�9� l w��+rl <br />Property address: z Y� • ��' �''/ N�/� <br />� Phone 1: y�- � L- y� � 7 Phone 2: <br />Email <br />� � • • <br />�. <br />�:.i�i��i.S'_�i�:.L_'L ....i <br />� � �!�.'�� i: �. �,� � <br />