Form ID

Publication date

Location of premises

Certificate

Sewer Modifications

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Burlington
Address of Owner
City Hall, 426 Brant Street, P.O. Box 5013, Burlington, ON L7R 3Z6
Name of Contractor
King Paving and Construction
Address of Contractor
3385 Harvester Road, Burlington, ON
Name of Certifier
City of Burlington
Address of Certifier
City Hall, 426 Brant Street, P.O. Box 5013, Burlington, ON L7R 3Z6

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

City Hall, 426 Brant Street, P.O. Box 5013, Burlington, ON., L7R 3Z6