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� 9 0 8 i—Fa y►- <br />BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicate lhat a backtvater prEvention device must be installed on the se�ver <br />connection at the address identdied on the enclosed letter Please help us veri(y� that our <br />informalion is correct by ansviering the folloering queshons about your propzrt� <br />Do you have a basement? Yes�No [' <br />If ye;, does it have piumbing fixtures (sink, toilet 'tlooi orain, e',c )� Yes ^ No�- <br />!7o you have a back�. rater valve on your sev✓er lire7 Yes G No � Don't Know � <br />Do you have a grinder p�mp in yo�r 6asement? Yes ❑ No ❑ Don't Knew 1� <br />Name. _ . �,��- <br />Frooerty address r2] ',3`'�,3_�-f�� V <br />Phene L _ Phone 2 _ <br />Finail. -- --- — -- - <br />- - —�7,-r ,�,— <br />1 �(y,�� � <br />-_ _. ��.N.l�ul.r��.:1:�.�.�' . . .. J�i'!��l �, �. ._u�_....1.. li� <br />