Form ID

Publication date

Location of premises

Certificate

Office Addition

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Larry Hudson Pontia Buick GMC
Address of Owner
1000 Wallace Avenue North, Listowel, ON N4W 1M5
Name of Contractor
Melloul-Blamey Construction Inc.
Address of Contractor
700 Rupert Street, Unit A, Waterloo, Ont. N2V 2B5
Name of Certifier
As Owner
Address of Certifier
As Owner