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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater pi-eve *ion device must be installed on your <br /> sewer connection to comply with the new ordmance. Please help us verify that our <br /> information is correct by answering the falletting questions about your property: <br /> Do you have a basement? Yes. ] No ❑ <br /> If yes,does it have plumbing fixturres sink t let,floor drain,etc.)? Yes ❑ No ❑ <br /> Do you have a backwater valve on your sew line? Yes ❑ No ❑ Don't Know <br /> Do you have a grinder pump in your basement? Yes ❑ No Don't Know ❑ <br /> Name: .P� <br /> Propert address: <br /> Phone 1: r— Phone 2: <br /> Email: <br /> ' N � t <br />