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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 11 No LI <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 c"No Don't Know ❑ �I '� <br /> Do you have fa grinder pump in your basement?a Yes ❑ Nog Don't Know ❑ <br /> _..)c') /C <br /> Name: V\ tM t €' <br /> Property address: 30 13 V� <br /> Phone 1: `f Zs'-2> Z -/ )nl t4i�-- Phone2: <br /> Email: j 6 k V1 fry �Z(e re "i"; .f'. (o t✓`'N <br />