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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 'No_❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes iNo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No LI Don't Know / <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know Lel' <br /> Name: 10 n \(AvvNI 0\di 04 140 <br /> Property address: b 1 \i r c i a i to . V p�V .Uv <br /> r�..l <br /> Phone 1 J �1/ 1�1! G J Phone 2: <br /> t <br /> Email: DI nok V Glut,t, (C/O 4 <br />