"You are hereby authorized and directed to shut off the supply
of water to the premises located at (give address) for the reason
that (name of owner or occupant), owner or occupant (strike out one)
of the above premises has neglected or failed to pay for a period
of 30 days from the due date thereof, a rental rate or charge for
sewer, sewage or sewage treatment service imposed by the Allegheny
County Sanitary Authority.
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"I certify that the owner or occupant of the premises above
set forth is the person responsible for payment of the overdue charge
and that such rentals, rates or charges are, in fact, overdue.
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"I certify that the above claim or lien for the aforesaid service
or services has been assigned by the Allegheny County Sanitary Authority
to the Borough of Avalon.
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"I further certify that written notice to the effect that the
water supply would be shut off at the above premises was mailed to
__________, owner or occupant (strike out one), at (address) on (date),
and further, that a written notice to the effect that the water supply
would be shut off at the above premises was posted at a main entrance
to the aforesaid premises on (date) by (name or poster). Copies of
the notice sent and the notice posted are attached hereto and made
part hereof.
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"I further certify that no written notice has been given the
Borough of Avalon or the Allegheny County Sanitary Authority stating
that __________, the aforesaid owner or occupant has a defense to
the aforesaid overdue sewage rentals, rates and charges.
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AUTHORIZED OFFICER
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