Form ID

Publication date

Location of premises

Certificate

Backfill mine shaft opening to surface

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Steve Belanger
Address of Owner
1459 Lakeshore Drive, Cobalt, ON
Name of Contractor
Mindecom Industrial Constructors Limited
Address of Contractor
667 St. Clair Street, Subury, ON P3E 4G9
Name of Certifier
C.D. Hamblin for MNDM
Address of Certifier
933 Ramsy Lake Road, 4th Floor, Sudbury, ON P3E 6B5

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

MNDM, 933 Ramsy Lake Road, 4th Floor, Sudbury, ON P3E 6B5