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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 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 inder pump in your basement? Yes ❑ No ❑ Don't Know, <br /> Name: C12 4 XG- <br /> Property address: 7 If ,�-�'`c'/ /T <br /> Phone 1: i{Z„S-SSE S• %?--C Phone 2: 2C6 ' g,7, 9736 <br /> Email: Ci/U 4=Z— C`Jxj /J�C•' �✓•./� ��_ <br />