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BACKWATER PREVENTION DEVICE 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 p'No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes �o ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑,No ❑ Don't Know LV <br /> Do you have a grinder pump in your basement? Yes �o ❑ Don't Know <br /> V ❑ <br /> Name: 676 i V{ <br /> Property address: 6(e to40(46-r- <br /> ri v e v <br /> Phone 1: ttI34V rS Phone 2: <br /> Email: _ ..�7, 71/11/15 <br /> ", <br /> ` _ Y z`La443y k. <br /> F i. <br /> .._ a t »a ,"? -k"� ::s�1;.u, i .. '' Ott � .ak,',t` <br />