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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 No ❑ t(2JIAQ l`" R <br /> If yes,does it have plumbing fixtures(sink,toilet, loor drai etc.)? YesX No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know gj <br /> Do you have a grinder pump in your basement? Yes ❑ No V A" Don't Know ❑ <br /> Name: I !1 c Cis &f l I l V'OJl t� � <br /> Property address: £33O / of n ter T -v"' t i Eizo W <br /> Phone 1: )1025 a13 1 6:4 Phone 2: y 2 —2,5 Z— 3/31 6.1 ) <br /> Email: no Y CeaQr.11.00. co rA <br /> :.. .�.._ , - � r t,.'_ ,.,x u,;1 a� nk n ... :''ci '� �3: 1.,,.ai_ 4,1111 <br />