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.11111111111111111111111111111111111111111111111.17,71 A <br /> • <br /> AColtk% ZEFZFRt\IENTION 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 1 No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes Y" No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know '4 <br /> Do you have a grinder pump in` your basement? Yes ❑ No ❑ Don't Know <br /> t/Name: fit✓ 1 1r 15 <br /> I <br /> Property address: '`Q 1V Oct.IIeg <br /> Phone 1:CiolS.A.G140 Phone 2: "1.s'ai3.c3'7 1 <br /> Email: eel,/ • <br /> L__ 11 y- ,.L s_� <br />