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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.)? Yes/6-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 z No ❑ Don't Know ❑CSt..s r�0 <br /> Name: J C.ACI i 11 /. 47ccv —, ' <br /> Property address: /3/5 gam/ z 1 Cld�hz <br /> 7520/ <br /> Phone 1 rj - 9,59 7 Phone 2: <br /> Email: <br /> � r ' <br />