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BACKW, R. EVENTION DEVICE PROGRAM <br /> 6 SEP s <br /> Our records . ica iat a backwater prevention device must be installed on your <br /> sewer Conn C n mply 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 [3"No ❑ <br /> If yes,does it have plumbing fixtures sink toilet,floor drain,etc.)? Yes eNo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know Ie" <br /> Do you have a gr der pump in your basement? Yes ❑ No Don't Know [ " <br /> 7 <br /> Name: <br /> Property address: / � — <br /> Phone 1 � �/9 Phone 2: <br /> Email: <br /> jp1 <br /> y.m �=�~ i <br />