BOROUGHOFCOLLEGEVILLE
GEOTHERMALHEATING/COOLINGSYSTEMINSTALLATION
PROPERTYOWNERCERTIFICATION
___________________________________________________herebycertifies
(propertyownernameandaddress)

thatthegeothermalheating/coolingsysteminstalledat
_________________________________,Collegeville,PA19426,

(address)
willbemaintainedinaccordancewithCollegevilleBoroughOrdinanceNo.548.
___________________________________________
PropertyOwnerSignature
___________________________________
Date
Onthis_________________dayof________________________,beforeme,theundersignedofficer,
a Notary Public, personally appeared _____________________________, known to me to be the
____________________________________________________, whose name is subscribed to the within
instrument, and acknowledged that he executed the same on behalf of ______________________ for the
purposesthereincontained.
INWITNESS
WHEREOF,Ihavehereuntosetmyhan dand officialseal.
_______________________________
NotaryPublic
MyCommissionexpires: