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yee,fc Qi A 6a.,A.. a- 5 .�z <br /> . -v- Cvk1cor-k. 6 c.t1-e- d td t ))it C <br /> Gt Lc�ck t +� Gav baS ►ate✓rf-- id0+4,r cc.1.t,�tLt� - I%e ci re aired <br /> f 1ii 5�w ti� � (vi S }-milted Gt l�a jc. ! �cr�t a <br /> BACKWATER PREVENTION DEVICE PROGRAM c,J.42,1 , k7e <br /> Our records indicate that a backwater prevention device must be installed on your _Jo rob j p , � <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'rogt.No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes/4 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 Don't Know ❑ <br /> Name: f; h YI d K(,,t✓'eY1 <br /> //�� J C�j✓ (�.i� <br /> Property address: I g I J�tAcke Y Au.e ue r q g'R a <br /> Phone 1: y 2.S';Z5"V_ 1763 Phone 2: <br /> Email: c;Gk.SC..(iiYle Y � ci3m ,'C3l-s"r, net <br />