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., r; <br />• BACKWATER PREVENTION DEVICE RRaGRAM .. <br />- Our records indicate ihaf a hackwater prevention device must be installed on your <br />sewer conneclion in comply with the new ordinance. Please help us verify Ihal our <br />information is r.orrect by answering ihe following questions aboul your property <br />Do you have a basemenl? Yes 5� No ❑ <br />If yes, does it have plumbing fixiures (sink, toilet, floor drain, etc.)? Yes �No ❑ <br />Do you have a backv+ater valve on your sewer line? Ycs ❑ No. ._J Don't Kno�v � <br />Do you have a gnnder pump in your basement� Yes ❑ No � DonY Know � <br />Namc. ._ �(�O�I�� �PcCC''R�� <br />Propertyaddress: 2,17 �� lAl/}} '1ve �I/ _ �1�1 <br />1'honet. �J���� � �hone2 �'��/3._x37% <br />Finail N.I G C'_�__�4 LC�"r GC�_�h� � C..p �.t�( — — <br />--- .,;����;�,, „��t�t���:�:. . <br />=-=`'' :,1�,c4l;���.1��n1���'���11:j���:��ui�1,R��;�l•�1��....����itti.,x,� o. <br />