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M.kiONG 1 oort-sc •, go v 21h ST S <br /> Mdtvns1uf.A. <br /> gg026 <br /> BACKWATER-PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? es No ❑ <br /> If yes,does it have plumbing fixtures€k toilet,floor drain,etc.)? es No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ *It-Kno <br /> Do you have a grinder pump in your I v l/basement? N Yes ❑ o Don't Know El <br /> Name: / aW'7(T -u l t' -1 <br /> Property address: AOO ( G 1NO Ave , EVE E i l <br /> J <br /> Phone 1: Phone 2: <br /> Email: <br /> ` :` ai <br /> .`',� "bpi g <br />