Form ID

Publication date

Location of premises

Certificate

Sanitary & Watermain Connection

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Mrs. Jasmine Singh, executor of the estate of Walter S.A. Singh c/o Thompson MacColl & Stacey Barristers and Solicit
Address of Owner
1020 Matheson Blvd. E., Suite 5, Mississauga, ON L4W 4J9
Name of Contractor
Cobra Drain Co.
Address of Contractor
40 Bradwick Drive Unit 1, Concord, ON L4K 1K9
Name of Certifier
Charlton Engineering Limited
Address of Certifier
1140 Burnhamthorpe Road West, Suite 105, Mississauga, ON L5C

Identification of Premises

Parts 1, 2, 3, 4, 5, 6 & 7 Plan 43R-22903

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

Thompson MacColl & Stacy Barristers and Solicitors, 1020 Matheson Blvd. E., Suite 5, Mississauga, Ontario L4W 4J9