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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 INo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,Coor dram etc.)? Yes Zo ❑ / <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 Don't Know ❑ <br /> Name: ° t5�e I e- <br /> y <br /> Property address: /52 Z i&k,- / "e- <br /> Phone 1:yZf3'03 l Y5a Phone 2: <br /> Email: <br />