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i <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 answering4tie following questions about your property: <br /> Do you have a basement? Yes 14 No ❑ <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 ❑ Don't Know [v]/ <br /> Do you have a grinder pump in your basement? Yes ElNo 'Don't Know ❑ <br /> Name: yflV6/ )/l AIGf <br /> Property address: � ha✓✓d Ave , 1/$Y6 A / z,/ <br /> Phone 1: 2!3 — 2i Phone 2: <br /> Email: ')►Lti <Z(,y t," l dt,oy hk AL . coo. <br />