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' <br /> 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 t 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 f h K <br /> Do you havePa '1VW a grinder pump in your basement?,Yes ID No El Don't Know, <br /> Name: �.I LAc o f <br /> Property address: I '[ t ei <br /> Phone 1: 7 2212 1-61.0 ?3 Phone 2: ^� <br /> �J j CO Email: �� � � �� � W�(it,l <br />