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BACKWATER PREVENTIONr►EVICE 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 X No ❑ <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 Don't Know ❑ <br />Do you have a grinder pump in your basement? YesX <br />No ❑ Don't Know ❑ —� r�� t01 <br />a d otl (1 R U GrA Sra n �'�`"` 1 #, <br />Name: Ipr1/*ID <br />Property address: Y r O I 2— 1A t° r ev-tpe,0.I:Il't.'1O <br />u <br />Phone 1: f !—S— ?J3 — o 0 3 _ Phone 2: <br />Email: <br />