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`BACKWATER PREVENTION DEVICE PROGRAM <br /> • Our records indicate that a backwater prevenjon device must be installed on your <br /> .: sewer connection to comply with the new,orclinance.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 ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes GI 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 Et n't Know ❑ <br /> Name: ikc co 'i <br /> Jo <br /> Property address: L 5 L1 Hay+Alie. <br /> Phone 1:f.,�7�5)2-O/ 3- Phone 2: 1c;t, '" " <br /> Email: rt Cc) r <br /> : .5,S}}. m...�,z c „'' ?__s „'`:r- a�z.>�u . v " �.>ttr _,v: k,,, 1 <br />