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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 IA No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? YesX No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know°K <br /> Do you ha�ve)a grinder pump in your basement? Yes El No ❑ Don't Know l��j <br /> Name: `� e lalic C-U' <br /> Property address: �-dy �R GLick iJ AviLL <br /> Phone 1: Cr(U 0 2-c ' Phone 2: <br /> Email: SQQMS ink( 5O 1I C , Con-) <br /> 4.001 <br /> �, ��� � . u. ., „. <br />