Form ID

Publication date

Location of premises

Certificate

Completion of new residence.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ann Johnstone.
Address of Owner
Pt Lot 6, Lot 26, Concession 6, Town of the Blue Mountains,
Name of Contractor
Patrick B. Coulter & Associates Inc.
Address of Contractor
2 Mountain Road, Unit 11, Collingwood, ON L9Y 3Z8.
Name of Certifier
Ann Johnstone.
Address of Certifier
175 Old Lakeshore Road, Town of the Blue Moutains, Ontario.

Identification of Premises

Pt Lot 6, Lot 26, Concession 6, Town of the Blue Mountains, Ont.