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BACKWATER PREV- NTIO*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 ►I No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes No ❑ <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 g Don't Know ❑ <br /> Name: 0 Cs.;NeN e C` ` - c J 'e-- <br /> Property address: N S 3 1 \\ <br /> Phone 1:Y25 2 5 7- 1 1 60 Phone 2: `t 2J V-29. <br /> Email: -e<AV G‘",-‘ GC�Vti Cc�S� ' V1�� <br /> Y3 <br /> . F7—:h7 ._.s .S-3:�.d a...ram'.�� ux 4:.?e'K � a���3... 4 ,. '-'a.sI 14: i.S� <br />