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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. 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/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 ❑ <br /> Do you have a grinder pump in your aseement? Yes ❑ No/Don't Know ❑ <br /> " <br /> Name: ;?M MA �t vQ✓ 2&330 rAw,Lic, <br /> Property address: d 1 i..--owLbetr' <br /> Phone 1: 54 t`"Sen-s-4IG3 Phone 2: <br /> Email: a , r AA i ♦ L �144) ) c sv 9 <br /> a <br />