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(,tottSillttakd AA, .C10 - <br /> 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 1No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No 111 Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No Kr Don't Know ❑ <br /> Name: ,. C, c)tDoeineit <br /> Property address: 332. 6 rot/14 Ave <br /> Phone 1: 2 C 613 8 Phone 2: 23 z - `f <br /> Email: Jos eodaAneli 0-40nf a✓.Corn <br />