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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 154Io ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Yj<lo ❑ <br /> Do you have a backwater valve on your sewer line? Yes Y(No ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ElNo on't Know ❑ <br /> Name: V( L14% �;_. fbE13i....�iZ <br /> Property address: Z. -Z-c .fe,. Rid i -mil E2 :CC \.33 <br /> Phone 0A25> 2,'S'-S svic( Phone 2:`-$ 5) zz "41 <br /> 24.-1 <br /> Email: / �Q <br /> •_ 4��*iSj4-e.�'Ri-3..iu .. ss. ..... . .... .1141416.W.. a ..z .sa .4'r,. <br />