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J <br /> BACKWATER PREVENTION IV*, ICE 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? Yes No ❑ gy ") t Cr <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yet 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: 020104' <br /> Property address: (46 1 14 0 M 4- A u e, t Lrevriit <br /> Phone 1: y 2,S`-3o3-9%,5( !Phone 2: 5CO3 70'6 r <br /> Email: , • _ Iw.Gp.S4s i1' <br />