Form ID

Publication date

Location of premises

Certificate

Construction of New Well in the Town of Millbrook TSH Project No. 52-27278

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Cavan-Millbrook-North Monaghan
Address of Owner
1 King Street East, Millbrook, ON L0A 1G0
Name of Contractor
G. Hart & Sons Well Drilling
Address of Contractor
Box 850, Fenelon Falls, ON K0M 1N0
Name of Certifier
Totten Sims Hubicki Associates
Address of Certifier
300 Water Street, Whitby, ON L1N 9J2

Identification of Premises

Lot 11, Concession 5, King Street Former Township of Cavan, Village of Millbrook

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

Township of Cavan-Millbrook-North Monaghan, 1 King Street East, Millbrook, ON L0A 1G0