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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 Vr 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 ❑ No ❑ Don't Know <br /> Do you have a grinder pump in//your basement? Yes ❑ No 2 Don't Know ❑ <br /> Name: �i(�. �l.Yt ��U kreCiS'�`o <br /> Property address: _35 oil DckG yam'1 t.J, - <br /> {,�'` �t� J 1/ �"�,.t^G y�c <br /> Phone 1: I W.-3S`1-S� Phone 2: y�0'v #w ( 6147'`C I'd' <br /> Email: 4 • fo g • Lk'et iCa 4 coen <br />