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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`j 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 14 <br /> Do you have a grinder pump in your basement? Yes ❑ No X Don't Know ❑ <br /> Name: 'Dell JQ y1 d pi , <br /> Property address: c2t/ 3O $0.kP.r <br /> Phone 1: 'V?S 2g3-3P6 Y Phone 2: V S-,31 V-36ao <br /> Email: h p 5 VY1Sr1, (�Vln <br />