Form ID

Publication date

Location of premises

Certificate

erection of a dwelling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Cynthia June Emmons
Address of Owner
1044 Lucas Street, R.R. #4, Odessa, ON K0H 2H0
Name of Contractor
James Emmons
Address of Contractor
as above.

Identification of Premises

That Part of Lot 23, Concession 3, Geographic Township of Ernestown, now Township of Loyalist, County of Lennox and Addington being Parts 1, 2 and 5 on Reference Plan 29R-7871 subject to a right-of-way in favour of Trans-Northern Pipeline over Part 5 on Plan 29R-7871 described in Instrument No. 16786

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

Land Registry Office, Lennox No. 29, Dales Plaza, 10-2 Dairy Avenue, Napanee, ON K7R 3T1