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• <br /> " 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 ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes 61 No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know Pd <br /> Do you have a grinder pump in your basement? Yes ❑ No x Don't Know ❑ <br /> Name: V ai1 <br /> Property address: <br /> 1 <br /> Phone 1:d+ ,--� 3 C- Phone 2: <br /> . _. 2.,-""ate 3'" v s.3,«..W.•., .„ ,. . ., .a t,ik <br />