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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 14 No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes No LI <br /> Do you have a backwater valve on your sewer line? Yes g No ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ Nost Don't Know ❑ <br /> Name: c�®� fr1 g• �'Zf <br /> Property address: `7 a'9 &ra1?(ice /Ue- <br /> Phone 1: 41, .5,2 'l 2 9 Phone 2: ., 3699- 26,7Z. <br /> Email: — i,r 4,0 •, g{MQ e®ryl <br />