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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwster`prevention device must be installed on your <br /> 'sewer connection to comply with the'new ordinance. Please help us verify that our <br /> inforrnation is correct by answering the following questions about your property: <br /> Do you have a basement? Yes E*No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes" 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 your basement? Yes No ❑ Don't Know ❑ <br /> Name: Si r i� ec C U z- <br /> Property address: <br /> 7°0 /-1"ov f A �Vey' <br /> Phone 1: ( 2 5— 25 2'_11—/4&c Phone 2: ,-}— <br /> Email: S. (A,h U LX `/�tM Ca6rtA Pe` <br /> . _ .. _ ,,.. ...a..,..- _ <br /> e <br />