Form ID

Publication date

Location of premises

Certificate

Proposed Shop Addition

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1418933 Ontario Inc.
Address of Owner
110 Canam Cres.
Name of Contractor
Grassmere Construction Ltd.
Address of Contractor
49 North Street East, Tillsonburg, ON N4G 1B4

Identification of Premises

Plan M286 BLK L