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_ � :_ _ _ __ __ _ _ <br />, , � ;n�;�; � � <br />� � ���� ,».�� � , - <br />, BACKINATER PR�VE�ITl�C3N DE�/ICE PRGIGRANi <br />Uur records indicate that a backwa.ter prevention dsvice rt�usi be instalted on yaur <br />sewer cnnnection to cori�ply with the new ordinance. Pleas� help us verify that our <br />information is correct by answering the fallowing questians abouf your property: <br />�]o you have a basement�? `fes No ❑ <br />�� <br />If'yes, does it have plurnbing fixtures �sink, toifet, floar drain; etc.)? Y�s No ❑ <br />do yau haue a,6ackw�terva��e on yc�ur sewer fine? Yes ❑ Na ❑ D�n't Knaw <br />C?o you ha�ie a grind�r �ump in your ba$en�aent? Yes ❑ No Dnn't Know [] ' <br />/ � �j <br />N�me: � � � �t�... '� � ���� : � t`� '� <br />1 r �,. <br />��,,. <br />Property address: �,�� l,� �;�� �'�' � � ' �`"�< <br />Phone 1: ��� � �.,� ��� � Phane 2: `?��� ' ���-i ` ��'�.� ;f��'ji� <br />Email: ���'��i(�.� �+r�t��'��'����'�� ��i�.�(�. ����'�� <br />,_ <br />_ ... . �;` � � <br />r <br />,.� , , �,.-� <br />