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•BACKWATER PREVENT1O :DEVICE PROGRAM <br /> Our records indicate that a backwater+pretion device must be installed on your <br /> sewer connection to comply with the new.otdinance. 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 No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know g <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know-, <br /> Name: (4c)-r- a t net i + by) <br /> Property address:'/00% Gl -�id � <br /> Phone 1: Y'?� 3/ / -7 6.7 S Phone 2: <br /> Email: #al ,tiQ �( YY1/ bdl Va oO. �Ltin7 <br /> .r „ F.c=,_ <br />