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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 o ❑ 1� <br /> If yes,does it have plumbing fixtures(sink,toile floor drain, tc.)? Yes 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 ❑ No ❑ Don't Know ©� <br /> Name: (11 Vnl Q-�� C,-lC i/'y\Ck <br /> Property address: c� • C&Vr` Sc� '/1`i' <br /> Phone 1: ( J--cQ ^2,,016 0 Phone 2: 11-3 - 1 0 "� 3 <br /> Email: <br /> � � <br />