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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/o ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes ❑ No a— <br /> Do you have a backwater valve on your sewer line? Yes ❑ No 24Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No 4't Know ❑ <br /> Name: 1 kiOlik/Vtj.-- a <br /> Property address: L, D , <br /> Phone 1: 14(e lego( 461c-- Phone 2: <br /> Email: I�'1l✓ ) w, '"" `Csf, °IV <br />