You are hereby notified that on __________ (date), at __________ (time), I intend to begin excavating on the property located at ___________________ (address), which property adjoins your property to the __________ (north/south/east/west). The excavation will go below the bottom of the ___________ (north/south/east/west) wall of your building. While all reasonable care will be taken not to unreasonably endanger the safety of your wall during excavation, your attention is called to the unsafe condition of the _____________________ (north/south/east/west) wall of your building in that __________ (describe unsafe condition). You are advised to take adequate measures to protect the wall.

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Signature Date

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Signature of Witness Date