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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 No ❑ 21,, o(OLr fruau ,, izotir <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes ❑ No k � <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know a <br /> Do you have a grinder pump inyour basement? Yes ❑ No ❑ Don't Know S6 <br /> Name: �rc 10 t � Lv4-L <br /> Property address: J�1 1 r a r0E t ve • +843 <br /> i& <br /> Phone 1: 5%Cp,a2 phone 2: ��L `ii <br /> Email: <br /> F <br /> 111 <br /> � ' . <br />