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.94 <br /> BACKWATER PREVENTION bEVICE PROGRAM <br /> ro 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 fol .wing questions about your property: <br /> Do you have a basement? Yes o ❑ <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 ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No on't Know ❑ <br /> `3:74/ C_..-/ <br /> Property address: ( O 0(7,f 4( 4 ).Q . <br /> Phone 1: ---17J WPhone 2: <br /> Email: 40/1 17_' .0 Crb[Gl <br />