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1l <br /> 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 A 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 $L,Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No EL Don't Know ❑ <br /> Name: ,4AQ71., yvN � <br /> Property address: \ $ VjA:LA+Y' <br /> Phone 1: Lc -140 Z2.1..0 Phone 2: <br /> Email: (aQ+1f•.S Yv►C..© 't tip vaka.v4 „GQ 1s <br /> . ._,, a. ._ ' �. ,,. .. <br />