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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.)? YessNo ❑ <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 basement? Yes ❑ No ❑ Don't Know' <br /> Name: // ,via rwi1 <br /> Property address: 2 ZQZ i-1< 00 .S---l1 A <br /> Phone 1: .5d `r55- Cleide' Phone 2: <br /> Email: .1%,c4Cmo-1 !l Gc.r✓1 <br /> 1517. <br />