Form ID

Publication date

Location of premises

Certificate

Addition and Renovation to Existing Structure.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Larry Gross.
Address of Owner
Part Lot 37, Concession 12, Town of the Blue Mountains, Onta
Name of Contractor
Patrick B. Coulter & Associates Inc.
Address of Contractor
2 Mountain Road, Unit 11, Collingwood, ON L9Y 3Z8.
Name of Certifier
Lucien Delean.
Address of Certifier
528 Cassells Street, North Bay, ON.

Identification of Premises

Part Lot 37, Concesion 12, Town of the Blue Mountains, Ontario.