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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your - <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes No ❑ .5 V,b je.r t.rY'e.O.n ga <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes' ) No ❑ Stow poly <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know% <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name: Paif Cann � 1644 I, <br /> Property address: 3 :.a� ;-W QE5 <br /> Phone 1:42.6 NA. 1 Phone 2: 341%.O c72 ? l 433 <br /> Email: ac1rt 0-arve.flAbk lot ceb.Q�nrt .I. I ,C../Y' ` <br />