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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 V['No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes [1/"No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ErNo ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No [[Don't Know ❑ <br /> Name: (9Ya// /914eAcilr, <br /> Property address: //`/ J Df!1 ,�/-Y ./ w'. 1✓ecel <br /> Phone 1: 3- F5/,1 Phone 2: <br /> Email: <br /> r,F <br /> �v.4. ,, . s . ' <br />