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I <br /> 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 p",No ❑ 40.'E <br /> If yes,does it have plumbing fixtures(sink,toilet ' , c.)? Yes No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br /> Do you have <br /> la(grinder pump ,(in your basement? Yes 15o El Don't Know ❑ <br /> Name: r ( GkQ e o1'l.3 <br /> Property address: 1-1-0'k ( t J a <br /> Phone 1: D 0(0 <1 9 c a 19/ Phone 2: 'm o(p 49w 3349 <br /> Email: W1 ke oba l rGd(0 0% 1(Fc t- .cAt3 <br />