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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 IZNo ❑ <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 ❑v' <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know Yee <br /> Name: 0a-)'a C b a- e c'fi`e <br /> Property address: 3 /1/ ) 366 2 <br /> Phone 1: Z.�2'0-'�3 ec, Phone 2: a�� <br /> Email: OUXflojX cidha, �, <br />