Form ID

Publication date

Location of premises

Certificate

Structural Modifications

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Roman Catholic Episcopal Corporation of the Diocese of London in Ontario
Address of Owner
1070 Waterloo Street, London, ON N6A 3Y2
Name of Contractor
Hazen Masonry & Restoration Inc.
Address of Contractor
R.R. 2, Ingersoll, ON N5C 3J5
Name of Certifier
Allan Avis Architect
Address of Certifier
60 West Street, Goderich, ON N7A 2K3

Identification of Premises

12048 County Road 34, Concession NTR, South Part of Lot 293