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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 �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 �o I♦ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No II! Don't Know ❑ <br /> Name: 5('\cu ay2 D:at'rae,v) <br /> Property address: g-3 Q 1 4�1 trltV1(C T"I LI <br /> Phone 1: 1-tc35 a5a Phone 2: <br /> Email: 3 a-re:7 lO 10011 v?C/.-( 1 . CGS <br /> —4 <br />