Form ID

Publication date

Location of premises

Certificate

Renovation / Addition to Cottage

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Wayne Stecho
Address of Owner
352 New Forest Crescent, Waterloo, ON N2K 3W9
Name of Contractor
Zettel-Fischer Contracting Ltd.
Address of Contractor
p/o 458, Walkerton, ON N0G 2V0

Identification of Premises

Lot 34, Registered Plan 828, Former Township of Artemesia, Municipality of Grey Highlands, County of Grey

Office to which claim for lien must be given to preserve lien

Wayne Stecho, 352 New Forest Crescent, Waterloo, Ontario N2K 3W9