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1611 16TH ST 2022-05-18
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1611 16TH ST 2022-05-18
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Last modified
5/18/2022 11:45:43 AM
Creation date
5/18/2022 11:45:11 AM
Metadata
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Template:
Address Document
Street Name
16TH ST
Street Number
1611
Notes
BACKWATER VALVE
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_._ � <br /> �f�rl /�a ,S-, <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate ihat a backwaterprevenlion device must be installed on the sewer <br /> connection al the address identified on ihe enclosed letter. Please help us verify lhat our <br /> informalion is correct by answering the following questions about your property: <br /> Do you have a basement7 Yes�J No ❑ <br /> If yes,does it have plumbing fxtures (sink, toilet, Ooor drain, etc.)? Yes �J No � <br /> Do you have a backwater valve on your sewer line? Yes ❑ No� Don't Know ❑ <br /> Do you have a grinder pump in yo�ir basement? Yes ❑ No � Don't Know ❑ <br /> Name:�1�V2 i4���'/�/1't a�•-^-- �� <br /> Property address: ��/'3 ���j `.�' .Si /J� ll,�Gu L�p �.c� . !'J�� 7/ , <br /> Phone 1: 3(OU'-�S?- S/L J _ Phone 2: ��� `�T 7/ —�`+� � 3 <br /> L=mail: � ` "�/-��� !✓ `--.�S�i✓. �rJ�'✓� <br /> �— — — --- <br /> _ , r— ,:. <br /> �:- htit�� :: ;� ' �1 , <br /> . • — <br /> � . . ,:� <br /> � . � <br /> .: ,� ) ■� . I � � ' � . ' <br /> ..i3f�` _i -'i '._�. _ �_ ' if.9 -'_ Jr_�._..._.��._ � � : . .L.. �.. �.�.. _,. __. <br /> •'�".! <br /> .. ,. ',•�"i•. . <br />
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