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/ <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 the following questions about your property: <br /> Do you have a basement? Yes 2/No ❑ / <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? 'Yes E 'No ❑ <br /> Do you have a backwater valve oryour sewer line? Yes ❑ No ❑ Don't Know S <br /> Do you have a grinder pump in your basement? Yes ❑ No ErDon't Know ❑ <br /> Name: 0 ha rill( ems Vvf 1/r* <br /> Property address: 2, 9)1 �ttJ t 4 / //tt�re 1 / 1 (J2. <br /> Phone 1: 4 G,., - l 5'l�Ahone 2: <br /> Email: ( 1'") 4�� 1t� J P b to/ '1 VCR e, ( 'Ii eQ . civil <br /> f . .,..... ..,t ..& i,,asp," <br /> / <br />