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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 <br /> 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 orrnMA <br /> Do you have a grinder pump in your basement? Yes ❑ No Don't Know ❑ <br /> Name: O e1 h Giz_e_e-r)f e4 <br /> Al � n fig/ <br /> Property address: 3D /-, V eR_ c)�3 B I y o <br /> Phone 1:—(2S`25 300 Phone 2: /t <br /> Email: A� ree Ie a-1- / or) .��'. C.(�/� <br />