Form ID

Publication date

Location of premises

Certificate

Single family one storey residential dwelling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Jordan, John Edward and Phyllis Marcilla
Address of Owner
R.R. #5, Thunder Bay, ON P7C 5M9
Name of Contractor
539764 Ontario Inc. c.o.b. Kamphof Construction
Address of Contractor
R.R. #5, Thunder Bay, ON P7C 5M9

Identification of Premises

Parcel 10-4 Section 55M-553 being Part of Lot 10, Plan 55M-553, designated Parts 5 and 6 on Plan 55R-10760, Municipality of Oliver Paipoonge, District of Thunder Bay.