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4, 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, ,No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? YesX No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No N,Don't Know ❑ <br /> Do you have rinder pu,mp in your basement? Yes ❑ No V Don't Know III <br /> Name: PIJI E( 1 C J O f <br /> Property address: 3 8 21 AA d /11,", <br /> Phone 1: v s 22-/''i" Phone 2: o_S A 52 .3 Z2 <br /> Email: y W idg/1iJ (J% / J 60,17 <br /> a <br />