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�� ,. <br /> _ ��..+e m ri ��, u, �. <br /> r <br /> � �.BACKWATER PREVENTION DEVICE PROGRAM `� <br /> .:� r <br /> ,_ , �c <br /> Our records indicate that a backv�ater prevention devi�e musf be installed on lhe sewer `f <br /> wnnection at the address identified on the enciosed let:er Please help us verity ihat our <br /> information is correct by answering the following quastio�s about your property: <br /> �� <br /> Do you have a basement? Ye� No i � <br /> If yes, does it have p!umbing fixtures(sink, toilet, iloor dra�•, etc.)? Yes�j No ❑ p <br /> Do you have a backv�ater valve on your sewer line? Yes n No ] Don't Know �, C <br /> 1 <br /> Do you have a arinder pump in your basemenl7 Yes ❑ No � Don t Knov�.+] � <br /> i <br /> Name: S• 1�"1 . _S 1 �E: V � �-% � ____ � <br /> Property addross: � � �% �'� �- L'� ��' J 1 _ z <br /> y G(Jt�N/c �' <br /> Phone 1:��"�_s "�S�� -�'/ �� Phone 2y'�s 3� � -�7 D � _ CJ <br /> �ZL-Y10 V tJ-�L�� �L�� O <br /> Email: � <br /> z v '� � C <br /> �,,..-..�.�:�- .��. <br /> _� __ _ _._�_ 1• : .:. .` :_. .- _ . . _. _ ... _ . _ ..: � <br /> s-�- wv.,.\ &. 1. Qlp � � -1- �. e.runo-�� �- rzo4��� G.> 2Rh1 {� V�!.C-;l.�-� <br /> �-� i•l n An� o'f HE '2- T�24yrJ— �«1f�zr s ctv�� C�og��eCf _ on �z c�v a`� �` <br /> — — — --. - --- <br />�I I <br />