Laserfiche WebLink
.. / <br /> � <br /> ;- <br /> BACY:WATER PREVENTION DEVICE PROGRAM <br /> '' dur rccords indicale lhat a backwater prevention device must be installed on your <br /> sh�ver connection to comply�vith the new ordinance. Please help us verify that our <br /> ' in(ormation is correct by ansvrering the follotiving questions about your property: <br /> Do you have a basement? Yes� No ❑ <br /> If yes, does il have plumbing fixtures (sink, toilet, t�oor drain etc.)? Yes �No ❑ �p�, <br /> Do you have a backwater vah�e on your se�ver line? Yes ❑ No ❑ Don't Kno�v � i k' <br /> Do you have a grinder pump in your basement? Yes [�' No ��on't Know ❑ <br /> � <br /> Name �1��_IvU 1 h �f�'�l'1�� � UU�i� W <br /> Propertyaddress: ���''v ����� �� � - - � <br /> Phone 1:�a'S ^��Z'`T � j � Phone 2:��'' �J' –a�J��j '' 7 � Z� v��(� <br /> CbG C�� <br /> EmaiC _ — <br /> .- . •-.r _• – -• – � <br />