Form ID

Publication date

Location of premises

Certificate

Addition & Renovation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1295209 Ontario Inc.
Address of Owner
585 Wallace Ave., Listowel, ON N4W 1L8
Name of Contractor
Frey Brothers Limited
Address of Contractor
3435 Broadway Street, Hawkesville, ON N0B 1X0
Name of Certifier
Brian L. Shantz Ltd.
Address of Certifier
490 Dutton Drive, Suite B1, Waterloo, ON N2L 6H7

Identification of Premises

“registerable description of property”