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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the"address identified on the enclosed letter. 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,SO 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 A Don't Know ❑ <br /> Do you have a rinder pump in your basement? Yes ❑ No 'Al Don't Know ❑ <br /> Name: /4d 5 Pi/ /Z l r`,'i4 <br /> Property address: � � /J'L <br /> Phone 1: V° z Phone 2: / <br /> Email: Lix G'a/2/9T/n/ 1L <br />