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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 D' No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes jkj No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know g <br /> Do you have a grinder pump in your basement? Yes ❑ No Don't Know ❑ <br /> Name: Pei/7 iO4 , <br /> Property address: Cl ,7 / j <br /> Phone 1: 40-,J`'!a - ,jOq Phone 2: >--- <br /> Email: d di .r 'h ,c4,, 3(� lif M�f /s (/2,11, <br />