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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 grinder pump in your basement? Yes/__ ❑ No F.'"! Don't Know ❑ <br /> Name: C�hccriPis i_ e 4e/0 Jr <br /> Property address: / _6 Roc,)c KeV t4 6-ye re 19 7 504 <br /> Phone 1: Lt zs—co/- 7i I.Phone 2: 1f 2 '7/65 <br /> Email: (_._, &)C. - /Or. rkai <br /> V <br />