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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. 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 121 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 in your basement? Yes ❑ No ;K.Don't Know ❑ <br /> Name: M/ h <br /> v"7 n-- <br /> Property address: 17 / V� <br /> Phone 1: 2(>Ce-22lu s-074 7 Phone 2: <br /> Email: blGA=,Gtt/ cf .)/Y! CO-2-2 <br />