Form ID

Publication date

Location of premises

Certificate

Construction of new residence

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Herb Seath
Address of Owner
Lot 3, Plan 1112, Town of Blue Mountains, Ontario
Name of Contractor
Patrick B. Coulter & Associates Inc.
Address of Contractor
2 Mountain Road, Unit 11, Collingwood, ON L9Y 3Z8.
Name of Certifier
Herb Seath
Address of Certifier
#3, Blue Ski George Crescent, Town of Blue Mountains, Ontari

Identification of Premises

Lot 3, Plan 1112, Town of Blue Mountains, Ontario