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' , . �t '.ti�: . . . (/ <br />p6,,` f / <br />� � �:; i�; p � <br />� -- . } . . �d l -i e t f <br />.... .. .. � � ..Y <br />� ..�f'4��[A■���������Y���i�l� ��M��� f ����� 4/ <br />Qur records indicate that a ba�kwater pcevention d�evice must b� installed on the sewer <br />connection af the address identified on the enclosed lefter. Please help us verify that our <br />inforr�ati4n is carrect by answering tl�e foilawing questions abaut ycaur property_ <br />Ro you have a laasement? Yas'� �Jo ❑ <br />�.� , <br />if yes, does it #�ave plumbing fixtures (�K, tc��let;�oor drair�, etc=)? Yes �j No [� <br />Do you have a b�ckwafer �alve s�n your sewer line? 'Yes ❑ Na �. Dan't Know ❑ <br />Do yau have a grinder pump in your basemeni? Yes ❑:No �on'F Kns�w ❑ <br />� '� ��. <br />"; 3""'� <br />Name: ����. �_ °� ��. � ��,. � �� � �.�.:.�� � , <br />� � � �-��� <br />Property address. � �' �� �`` .� �. � �� �' ����y `�� ��# � �, .. `� �A��� - <br />Phone 9 ��' �.� ,����:. ,��"",,�� �� ���� Phnne 2: . <br />Email: ��a �=��, �,Y t�..' �-..�� ��,����� ��,, �'.��"�-�.��,«"��� � • �x-'�,.�-��F�f'� � � <br />