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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 No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Zr No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No Don't Know ❑ <br /> Do you have <br /> a grinder pump in your basement? Yes ❑ No ['Don't Know ❑ ' <br /> Name: Y A✓11 e f (G�if ft3 .-USS S Vsi(e <br /> Property address: 2 40'1 k `'P-e 9 820 1 <br /> Phone 1: 1 ST2t© G(o Phone 2: Li z S So g <br /> Email: Cain a i e((9— 1•4 0i C c`sP"l <br />