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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 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 <br /> p iin your basement? Yes ❑ No ❑ Don't Know [14 <br /> Name: �� " t- t4 X,-J✓I <br /> Property address: <br /> Phone 1: rl ZS 7o-IA Oa Phone 2: 3 5 �)ZO' <br /> Email: j (-i '2:bok'eG,-.b1. c.00, <br /> err <br /> . � ��. aa �3 � , , �, . t.a: <br />