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t, t'? `L. l``e i lc a t of . '%- 1 S' ` ` ti°` °i " `4 <br /> pet SSe ' ii Aug, i G - i ,"7 f-) s i8/ ' ",,w <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> ''''' 6" .j- .- '? C ti et v1,9e <br /> Our records indicate that a backwater ilrevention 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 /> r <br /> - Do you have a basement? Ye No (1 <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 ❑ NoJ Don't Know ❑ <br /> es) , <br /> ...f.,-,,.‘ Name: Ka t <br /> r,... <br /> ....,,, <br /> e?-7- <br /> Property address: t 702.. ,3e a. <br /> Phone 1: g026 Phone 2: <br /> Email: <br /> ' 'i` 1,4/1,5)1v <br /> - - ---- - ,,,,,,,,,..„ <br />