Form ID

Publication date

Location of premises

Certificate

Excavation & Backfilling & Site Grading

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Masarykpark Memorial Institute Incorporated
Address of Owner
450 Scarborough Golf Club Road, Toronto, ON M1G 1H1
Name of Contractor
Tom LaRue Excavating Ltd.
Address of Contractor
536 Sandford Road, R.R. #1, Uxbridge, ON L9P 1R1
Name of Certifier
J.S. Watson & Associates Ltd.
Address of Certifier
50 Acadia Avenue, Suite 207, Markham, ON L3R 0B3

Identification of Premises

Part of Lot #17, Concession D