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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 j81 No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes'VI No ❑ <br /> Do you have a backwater valve on your sewer line? Yes NI No ❑ Don't Know ❑ <br /> Do you have a grinder pump <br /> in your basement? Yes ❑ No X Don't Know ❑ <br /> P <br /> Name: Eo ) • <br /> ea <br /> Property address: J SCJ•2 V j,Q4://)l4 A V e <br /> Phone 1: ii..2S-91 3 '?"02ef. Phone 2: `" '‘'Qc2k51c2,26. <br /> Email: `� ��f/l/ eKt,c <br />