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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 M/No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? YessNo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No 1 i Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No ri Don't Know ❑ <br /> Name: O 4 h in 0,, �. <br /> Property address: L �J ' 7 ���� i� <br /> Phone 1: /1 _38'7. O37( Phone 2: 1/2-5-387-e73769 <br /> Email: �.C�13'l0o�,sQ� J utio C <br /> E,z x *161-Ifi LA, <br />