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0,z4f, <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 liNo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes'No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No g Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No 54 Don't Know ❑ <br /> Name: 7 K 2II b <br /> Property address: /3/6 _omimed Ay-, <br /> Phone 1: q25 3,30r /2'l Phone 2: tjas.3l 5-27 5 <br /> Email: j C-r\./aPvlJ'�9L 1140.9 . C-0)4. <br />