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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 Lam'No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Vo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know 2 <br /> Do you have a grinder pump in your basement? Yes LI No [Don't Know LI <br /> Name: CA e_ <br /> Property address: /6 0 6 -/-e -7 -4-7'7 !J/C <br /> Phone 1: gZ 5--,ZSL IlY', Phone 2: e/Z - <br /> Email: <br /> §,+,... ,i r+»,.n F'..,.:.," •`:v* S'-".-w ra 4'�z .? ....Y ��t�f,3 s !Alfa'`. ,..., .,a.. t i.. <br />