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;M, <br /> g <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> d <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 /> 3 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 fixtures(sink, toilet,floor drain, etc;)? Yes ❑ No 1�( <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: 1 <br /> 46 <br /> Property address: <br /> Phone 1: '7 �� Phone 2: <br /> Email: titin o -cc <br /> { <br />