Form ID

Publication date

Location of premises

Certificate

Completion of New Chalet

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
John & Teri Band
Address of Owner
119 Clear Water Court, RR#2, P O Box Q-O, Clarksburg, ON N0H
Name of Contractor
Patrick B. Coulter & Associates Inc.
Address of Contractor
20 High Street, Unit C, Collingwood, ON
Name of Certifier
Teri Band
Address of Certifier
119 Clear Water Court, RR#2, P O Box Q-O, Clarksburg, ON N0H

Identification of Premises

Lot 16, Plan 16M-6, Town of the Blue Mountains, Ontario