Form ID

Publication date

Location of premises

Certificate

Great Lakes Christian College, New Boy’s Dormitory

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Great Lakes Christian College
Address of Owner
4875 King St., Beamsville ON L0R 1B0
Name of Contractor
Owner
Address of Contractor
as owner
Name of Certifier
Jim Dickie, P.Eng.
Address of Certifier
R.R. #1, Vineland, ON L0R 2C0

Identification of Premises

CP3 Pt Lot 160 Pt Lot 161, Town of Lincoln