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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 <br /> '4 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 basement? Yes ElNo tikDon't Know ❑ <br /> Name: AN 7111-11 <br /> Properly address: 16111 NE ftt, �� I/VaV R 11C1 <br /> Phone 1:1I( Lb)I"t�)' Phone2: <br /> Email: uil* eAcq.)-ONA111,(101 <br /> g' ..a ..a _.. <br />