Form ID

Publication date

Location of premises

Certificate

Addition

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Faith Lutheran Church
Address of Owner
Same as above
Name of Contractor
Ball Construction Inc.
Address of Contractor
820 Victoria Street North, PO Box 1202, Kitchener, ON N2G 4G

Identification of Premises

Plan of Survey of Lot 1 RP 1020 & Part of Lot 36 RP 785, City of Kitchener