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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 ❑ No El <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 <br /> Do you have a grinder pump in your basement? Yes ❑ No Rf Don't Know ❑ <br /> Name: COA( 1,tX�-1 5/./LLOOS <br /> Property address: I2(( 1( g"7 Si'r (-..uj?((EZ71 U)A- <br /> Phone 1: 1/6(a Yg 0 C/ttnY Phone 2: <br /> Email: o2t&39- fit,AAM., ,cokt <br /> o t <br />