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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$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 ❑ Don't Know <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name:\?P)jjXO UA'C &J <br /> Property address: 2`2\ 'EV <br /> Phone 1: Sfl 1 2: NO <br /> Email: A .iti .t • Adk `J A , s t QV) <br /> — <br /> ..sw i"a:.dt, si� ,< .. ._,..,, k <br />