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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 g No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes xI 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.I <br /> Name: yd��'%/cif 0.92 E. <br /> Property address: /902 T�T/9 S • G U ce T T <br /> Phone 1: Zb4- 7/370 //.2 S Phone 2: <br /> Email: QF3'E/4/1//iVE e /rl-e7h11//0,e, A)ET <br />