Form ID

Publication date

Location of premises

Certificate

New building for Sturgeon Falls Pentecostal Church.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Sturgeon Falls Pentecostal Church.
Address of Owner
c/o D.R. Brohm, 174 Elizabeth St., Ajax, ON L1T 3Z5.
Name of Contractor
Sturgeon Falls Pentecostal Church.
Address of Contractor
c/o D.R. Brohm, 174 Elizabeth St., Ajax, ON L1T 3Z5.
Name of Certifier
D.R. Brohm, P. Eng.
Address of Certifier
174 Elizabeth St., Ajax, ON L1T 3Z5.

Identification of Premises

Part 1, Part of Lot 1, Concession 1, Township of Springer, District or Nipissing.