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1/4/ <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 thyfollowing questions about your property: <br /> Do you have a basement? Yes No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,e c.)? Yes o ❑ <br /> Do you have a backwater valve on your sewer line? Yes IV No pi Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No Don't Know ❑ <br /> Name: 'r�5 hi(A/5w<Ak <br /> Property address: i g)4 0(7 A Ye" <br /> Phone 1: /kS 3Z'i- 5?34t 9 Phone 2: <br /> Email: <br />