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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 I�Q No ❑ <br /> If yes,does it have plumbing fixtures m ,toilet, or drain etc.)? Ye;"No ❑ z. <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know N) <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name: " J i v A. <br /> Property address: 73a i,.t, j <br /> Phone 1: 4` _1 ,WT Phone 2: <br /> Email: 5't `i' 11 L1 co\ <br />