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BACKWATER PREVENTION,DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. 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 Eti No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Q No ❑ p" s0 <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know [ `q, <br /> Do you have a grinder pump in your basement? Yes ❑ No {Don't Know ❑ o•n <br /> Name: cs�a Ar2cS <br /> 11, <br /> Property address: ) 91/ 13 I Cli42,reti- f <br /> Phone 1: G c(/0 Phone 2: <br /> Email. ,## tit (Cf • oytdierscol �.�'zlc� � (CfriA <br /> 3 <br />