Form ID

Publication date

Location of premises

Certificate

Site Grading

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Outback Developments Ltd.
Address of Owner
45 Speedvale Avenue East, Unit 5, Guelph, ON N1H 1J2
Name of Contractor
Van Rooyen Earthmoving Ltd.
Address of Contractor
R.R. #4, Woodstock, ON N4S 7V8
Name of Certifier
Christopher R. Sims P.Eng. Gamsby and Mannerow Limited
Address of Certifier
Suite 210 255 Woodlawn Rd. West, Guelph, ON N1H 8J1

Identification of Premises

Dutch Mill Subdivision Part of Block B, Reg. Plan No. 544, Rear Part of Lot 7, Concession 8, City of Guelph (formerly Township of Puslinch) Arkell Road, Guelph, ON