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BACKWATER PREVENTIO 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 FrNo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know R <br /> Do you have a grinder pump in your basement? Yes ❑ No E Don't Know ❑ <br /> Name: GA-etc l/06/4' <br /> Property address: 3707 &914fAk e-94.) 4ae, lid ' 9 o3 <br /> Phone 1:44/V-6 'c=.9 1-146®0,-- Phone 2: 4/ S 9179-7tc • <br /> Email: 420,E ak T.Ch a 6217.1 <br />