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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device'rnu'stbe 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 0 No ❑ <br /> If yes, does it have plumbing fixtures (sink, toilet, floor`drain;)etc.}? Yes [K No [❑ <br /> ....,......:.. <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br /> Aj <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name: <br /> Property address: _ <br /> Phone 9: — =+ v' �/ Phone 2: <br /> Email: <br />