Form ID

Publication date

Location of premises

Certificate

Sanitary trunk sewer

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Lakeshore
Address of Owner
419 Notre Dame, Belle River, ON N0R 1A0
Name of Contractor
J.
Name of Certifier
Stantec Consulting Ltd.
Address of Certifier
3260 Devon Drive, Windsor, ON N8X 4L4

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

Clerk - Town of Lakeshore, 419 Notre Dame, Belle River, ON N0R 1A0