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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 , No ❑ <br /> If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)? Yes)K No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Knowe;;, <br /> !Al --Av. Do you have a grinder pump in your basement? Yes ❑ No k;A Don't Know ❑ <br /> Name: ,l f (' l�} CO Pfiit 'G <br /> Property address: 211-05" L/jr u ii4 t . Avolifel yrV'ei� 9g-,201 <br /> pp�� d <br /> Phone 1: T�, 31` - Phone 2: IQ = ` � � <br /> jaEmail <br /> ieaL7714h11if)' co <br /> ,I r <br />