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/ <br />� <br />BACKWATER PREVENTION DEVICE PROGRAM <br />O��r racords indicate that a backwater prevenlion devi ce m�st be ;nstalled on the sewer <br />cnnnection at lhe address ide�Lfied on the enclosed Iette: Please help us verify lhat our <br />informahon is correct by ansv�enng lhF� (ollowing questions abou� your property. <br />Do you have a basemenl7 Yes�� No ❑ <br />i � ��,,,, <br />If yes, does d have piwnbmg fiztures (sink, toilet, floor dr�in, etc )� Yes�No [i <br />De you have a backwater valve on y�ur se�^:er line7 Yes ❑ No ❑ Dor't Knova� <br />Da ycu have a grinder p�mp in your basement? Yes '� No�Don't Know ❑ <br />Name � � � � �C t. c� — - - - - <br />�- . <br />Property �ddress ��CS_�__� �_�_r��/ � _ _ _ <br />Phone 11�� �3 /_ Y.�,� Phane 2 ��� - %l � 7 � �3 <br />Fina, _ - - -- <br />i..J.����'�:�e'.�i:GI���`i�{`,:� ._iS;:�':ll�ttfi; �. <br />