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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 ❑ <br /> If yes,does it have plumbing fixtuures(sink,toilet,floor drain,etc.)? Yee 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 <br /> your basement? Yes ❑ No I on't Know <br /> V/ ❑ <br /> Name: GI'S " O(gr <br /> Property address: /d► Q/ /40#01-g. 5 U 61. <br /> ae / <br /> Phone 1:%16"--011� /J A Y7 Phone 2: v Wei <br /> Email: No-- <br /> go. .u»'Y 31 Ya y x . P t, <br /> �.1=���w �$'S�� $' ���h :'.3�e_ell-S _F�...x � .. .t ME,i ,u= tic. <br />