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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? Ye>R1 No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes ❑ Ne. <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 ❑ Nw Don't Know ❑ <br /> Name: Kh <br /> Property address: 563 a 0 1 131 <br /> Phone1: Phone2: Li/5-,3q.-13 1 <br /> [ Info ! c <br /> Email: j 'e � r � ® r `I/'VIf / /1 <br /> � rn <br />