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� J <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 pro arty: <br /> Do you have a basement? Yes)4 No ❑ In v+ ho045-e.S) <br /> C <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? YesX No ❑ C6 0` ")- <br /> Do you have a backwater valve on your sewer line? \\\T No ❑ Don't Know ❑ (1° <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name: 1) et vie } 'Male �QS le <br /> - , k q 4-Property address: I I - <br /> Phone 1: lid J .b16(4' Phone 2: <br /> Email: —1 D SAS y L Co' '. <br /> t <br />