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z <br /> 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? YesX, No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes)g No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know i 1 <br /> Do you have a grinder pump in your basement?ba � Yes ❑ NoADon't Know • <br /> Name: V i Vôt1L Y kb' <br /> Property address: I 7 ! 7 D <br /> Phone 1:125 C)35 3 Phone 2: <br /> Email: (IL ,�7'� <br />