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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 A No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes E No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br /> Do you have a grinder pump/din your basement? Yes ❑ No [73. Don't Know ❑ <br /> f ' <br /> Name: C.if Ll A y. ' - 1/4 of I f `)3�j.^:v <br /> Property address: (}►%� 1 2 k.�:6 C G':"I 31 :91/e <br /> Phone 1: '(i� 3 %_-3 Phone 2: f <br /> Email: .L_ !M 7 Le G,c..v. „_e, c' � yr kn.. IC Y C f if <br />