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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 gi 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 <br /> Do you have a grinder pump in your basement? Yes ❑ No gici,Don't Know ❑ <br /> Name: 1ktit"1'tk"it.1\a,,A <br /> Property address: I, t t>L. FE I tr:.,` Q e®'rye /; ''A\yt <br /> Phone 1: 1 1,`) `> - t‘ (-• Phone 2: <br /> Email: <br /> ;LI,ter_ .�.. .,... � ..te� •a r <br />