Form ID

Publication date

Location of premises

Certificate

Placement of Surface Treatment/Minor Grading Improvements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Lennox & Addington
Address of Owner
97 Thomas Street, Napanee, ON K7R 4B9
Name of Contractor
Greenwood Paving (Pembroke) Ltd.
Address of Contractor
1495 Pembroke Street West, Pembroke, ON K8A 7A5
Name of Certifier
Darrel Lott, C.E.T.
Address of Certifier
97 Thomas Street, Napanee, ON K7R 4B9

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

County of Lennox and Addington