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BACKWATER PREVENTIONEVICE PROGRAM <br /> .. <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;51 No LI <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 ❑ Don't Know ❑ <br /> Name: i i;,--$ WMN.• <br /> , H1 WT <br /> Property address: 4-1 1' 1. a b/ 4v& <br /> Phone 1: (/ Phone 2: <br /> Email: #34c ukrgir �{d,, e f7rw Ca- i h-4±- <br />