Form ID

Publication date

Location of premises

Certificate

Installation of Sanitary Forcemain and Lift Station

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Credit Valley Conservation
Address of Owner
1255 Old Derry Rd., Mississauga, ON L5N 6R4
Name of Contractor
Jackson-Tkach Inc.
Address of Contractor
P.O. Box 85070 Brant Plaza Postal Outlet, Burlington, ON L7R
Name of Certifier
RAND Engineering Corporation
Address of Certifier
5285 Solar Drive, Mississauga, ON L4W 5B8

Identification of Premises

Part of Lot 11, Con. 3 W.H.S.