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BACKWATER PREVENTION DEVICE PROGRAM <br /> ;gut records indicate that a backwater pr4vention 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 X No LI <br /> If yes,does it have plumbing fixtiAes(sink,toilet,floor drain,etc.)? Yes ❑ No E <br /> Do you have a backwater valvelr your sewer line? Yes ❑ No ❑ Don't Know gi <br /> Do you have a grinder pump in� P4Z <br /> yoo�ur basement? Yes LI No N Don't Know ❑ <br /> Name: Roerkl— /°��t. ///1 <br /> Property address: V 2O -- 4.0i13/9/ 19 ��ld 9 <br /> Phone 1:#V5:;?"- =,> 73 Phone 2: -33'0R 17 f <br /> Email:.bob,pot_ ,c / k! co147G Ots'1 ,� <br />