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BAKWATER 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 1K No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes ❑ No M. <br /> Do you have a backwater valve on your sewer line? Yes 54 No ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes It No 'i Don't Know Jj <br /> r 1-►A-VE S_►149 __ _ <br /> Name: LO U i S, 7'V111k-6.d4J'ik.g 054 <br /> Property address: 2(o o Q At,tZs-S A(t . <br /> Phone 1: 1 Z 'ZS "4 b9it Phone 2: <br /> Email: <br /> fi Sib� f C <br /> , <br />