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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 jv 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 0 M 4 4 f 6'P <br /> Do you have a grinder <br /> pump in yourr basement? Yes ❑ No Don't Know ❑ <br /> �Name: iG �C a` d � q OrC <br /> Property address: ) 3 , 1 _ 47 2 <br /> Phonert i/s '� _ (4/22- Phone 2: <br /> Email: <br />