Laserfiche WebLink
BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevenlion dev�ce must be installed on your <br /> seerer connedion to comply vdlh lhe new ordinance. Please help us verify that our <br /> mformation is correct by answenng the following questions about your property <br /> Do you have a basement? Yes (/J No ❑ <br /> If yes, does it have ptumbing fixtures(sink, toilet, iloor drain, etc.)7 Yes [ No ❑ <br /> Do you have a Gack�valer valve on your sewer line? Yes � No ❑ Don't Knoa� � <br /> Do you have a grinder pump in your basement� Yes ❑ No [�'j�Don't Know ❑ <br /> Name: ,�,L��2L'1—��(�ll� <br /> Property address: � 3 v .� � /'Gs�/� l7 U-e. _ __ <br /> Phone t y�S� �• i/� Phone 2 _ _ ____ <br /> [mail _GFj T•� � �O/ �^ �/"1 _ <br /> _ z , � <br /> .�,.. .a, .,, _.i... t. , �.' ��;: {'r i . .;,:. i ,k . <br />