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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 P to ❑ <br /> If yes,does it have plumbing fixtures,(sink,toilet,floor drain,etc.)? Yes-E1--No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know El/ <br /> _ Do you have a grinder pump in your basement? Yes ❑ No on't Know LI <br /> Name: 2 p ��n. 0104,�R <br /> Property address: IL-) V ►r5 L y. (ra Ae,E,JR r to 9 <br /> Phone 1: -1 24 7i(''3 O(i Phone 2: (+2,J5- 3 -,s--azsG <br /> Email: `kFti)f•8%Sok @ t+ )41,J. �-`'y <br />