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BACKWATER PREVENTION DEVICE PROGRAM <br /> ram' <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.)? Yes, 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 X Don't Know ❑ <br /> Name: / i7Qfe <br /> Property address: (J 6 b i <br /> Phone 1: SIZS. 5/• 33 5/Phone 2: 10 26,3 .3 SZ/ <br /> Email: 0/_ i.[G. Q "norm rAl'AI PA /t'<C 3,4 t4'4--.cow( <br /> � <br /> �� `�s ����'a���� ��H e„.a�..�xr.,t ,,,....� ,,.. ,.. ,' t c?tv�'?.��' ._sl <br />