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J <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> 1;1 <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 ,i No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes XI No ❑ <br /> Do you have a backwater valve on your sewer line? Yes No ❑ Don't Know ❑ <br /> Do you have a grinder pump inn your basement? Yes ❑ No Kr Don't Know ❑ <br /> Name: £L D a": f.1&RC B U <br /> Property address: ,5 / f1C' )'/ <br /> Phone 1`12.S S'q 177.1s" Phone 2: 115"c' 3317 r J f <br /> Email: <br /> 3 . ,,.. <br /> � � Wiz �.,. , s., <br />