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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 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 1S No ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No 'Don't Know ❑ <br /> Name: David Bei c er <br /> Property address: 15a 5 /40Y+ Alit ,fiver€-H- wig q8a ci <br /> Phone 1: /ol.`j-075.2-Bernd l/ Phone 2: a 3 ` - 7 7.2 2 <br /> Email: )e )che rd Q- bubo, Cox/ <br />