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• BACKWATER PREVENTIO`IhEWCE 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 w <br /> /❑ Don't Kno <br /> Do you have a grinder pump in your basement? Yes El No 6on't Know ❑ <br /> Name: Ja iit./ O4oRj uLA <br /> Property address: l 02Gi P4/1.✓t1-tit 1911f <br /> Phone 1: Z'?,, Phone 2: <br /> Email: 1�-( r <br /> � At,e „ ..,,,_. a . ,_ ,.�__ <br />