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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 comp17 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 ❑ 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 yourl basement? Yes El No El Don't Know <br /> `4 Name: t ` as' `if v'� <br /> (Property address: le 1 5,�,' 2 ' C <br /> {iv L. <br /> Phone 1: ' " <br /> �✓ Phone2: (0°-`a00--c q/ <br /> Email: Sw o vk &wtvt <br /> 4., " <br /> 'n,�� .:, 4 f <br />