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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 2I/No ❑ <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 [ti]� <br /> Do you have a grinder pump in your basement? Yes ❑ No [t�Don't Know ❑ <br /> Name: Pt-ad .,' ,fa i <br /> Property address: v� �/iRL,-/f2}' `I <br /> Phone 1:l O(P '1(2Z �a�7'5 Phone 2: <br /> Email: Ct 1 6I'i, , , I t. ,C <br />