Form ID

Publication date

Location of premises

Certificate

Sanitary Pumping Station

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Wildwood by the River Bayfield Park
Address of Owner
PO Box 901, Bayfield, ON N0M 1A0
Name of Contractor
Lavis Contracting
Address of Contractor
R.R. #2, Clinton, ON N0M 1L0.
Name of Certifier
Development Engineering (London) Limited
Address of Certifier
361 Dufferin Avenue, London, ON N6B 1Z5

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

Addresses as above