Form ID

Publication date

Location of premises

Certificate

Casey’s Restaurant

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Prime Restaurants of Canada Inc.
Address of Owner
10 Kingsbridge Garden Circle, Ste. 600, Mississauga, ON L5R
Name of Contractor
Prime Restaurants of Canada Inc.
Address of Contractor
As Above

Identification of Premises

Blocks 175 & 176 - Reg. Plan 20M-813 - Block 115 Reg. PL 20M-851, Lot 15, Concession 4