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BACKWATER PREVENTIONVEV10E 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 III <br /> If yes,does it have plumbing fixtures dp` , loor dra' etc.)? Yes Lyi. No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No g. Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No V Don't Know ❑ <br /> i g <br /> Name: 2 1 A , / <br /> Property address: �'7 11 urt'f-1- V-€ <br /> Phone 1: tY5 �i`G1 c)(r' 0S Phone 2: <br /> Email: Pi<ce tiA "ICA.h0() • C_O,i <br />