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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 1. No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes gi No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No°IR] Don't Know ❑ <br /> Do you have a igrinder�pump in( your basement? Yes ❑ No ig Don't Know ❑ <br /> Name: I( ar1Gf Uul(e/' ni owe-- �i <br /> Property address: 6 1 L`I O/f�na`J7l V C- C�C�/ '/ /mow, <br /> Phone 1:_ 2 qD3`- 2iq/ Phone 2: L %o "-15b5 <br /> Email: " IQJ ti l� oyahoo. coni <br />