Form ID

Publication date

Location of premises

Certificate

Phase I (Block 1-5)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Pinelands (2002) Inc.
Address of Owner
c/o Trillium Resort 848 Clearwater Lake Road, Port Sydney, O
Name of Contractor
Tech Home Ltd.
Address of Contractor
130 Konrad Crescent, Unit #18, Markham, ON L3R 0G5
Name of Certifier
Fred Haas - Dianne Mowbray
Address of Certifier
Konrad Crescent, Unit #18, Markham, ON L3R 0G5

Identification of Premises

Lot 33 & 34 Con. 3 Geographic Township of Medora, Township of Muskoka Lakes District Municipality of Muskoka

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

15 Dominion St. N., Bracebridge, ON P1L 2E7