Form ID

Publication date

Location of premises

Certificate

Phase 1

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
MNR
Address of Owner
RR #1, Pass Lake, ON P0T 2M0
Name of Contractor
Towland-Hewitson Construction Ltd
Address of Contractor
845 Old Goulais Bay Road, Sault Ste. Marie, ON P6A 5K8
Name of Certifier
Terri Jakobsen
Address of Certifier
Sleeping Giant Prov. Park, R.R. #1 Pass Lake, ON P0T 2M0

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

Sleeping Giant Prov. Park, R.R. #1 Pass Lake, ON P0T 2M0