Form ID

Publication date

Location of premises

Certificate

Road Construction and Drainage Works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Glenn Lothian
Address of Owner
9 Lytle Lane, Kirkfield, ON K0M 2B0
Name of Contractor
Doing It Right
Address of Contractor
90 Albert Street, Coboconk, ON K0M 1K0
Name of Certifier
Glenn Lothian
Address of Certifier
9 Lytle Lane, Kirkfield, ON K0M 2B0

Identification of Premises

Parts 1 to 5, Both Inclusive, Plan 57R-10564

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

Glenn Lothian 9 Lytle Lane, Kirkfield, Ontario K0M 2B0