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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, J No ❑ <br /> If yes,does it have plumbing fixtures`` sink tXrfloor 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 Don't Knows'/ 140 <br /> Name: -2t",WA-. s% <br /> Property address: 27-1-1 H.03* AV-IL . -' -Q slebt <br /> Phone 1: 4 ;Phone 2: yq <br /> Email: r aft t 1 i A_ _.I 'ICI • Y/�4 <br />