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• BACKWATER PREVENTION DEVICE PROGRAM I WJ <br /> Our records indicate that a backwater prevention'. Mice must be installed on your <br /> sewer connection to comply with the new ordinance Please help us verify that our U.4 ll? <br /> information is correct by answering the following questions about your property: t- <br /> ItDo you have a basement? Yes VNo ❑ O <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes E No ❑ 'L <br /> Do you have a backwater valve on your sewer line? YesX No ❑ 2v l` <br /> � J <br /> Do you have a grinder pump in your basement? Yes KrNo ❑ Don't Know LI <br /> 11 avC <br /> Name: iC S <br /> Property address: ��83 f 7k(b4 - 4 iU <br /> Phone 1: l(v `775 Phone 2: &7S' .2ZC, 'QZ5�' 1 <br /> , 0..._Email: 0/1d1/kC C4A5 Z �irr�K (•era CGw► <br /> Aim { <br />