Form ID

Publication date

Location of premises

Certificate

°µÍø½ûÇøion of Single Family Residence & Barn

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Heather & Jim Peterson
Address of Owner
384008 Hickory Acres Drive, RR 2, Harrow, ON N0R 1G0
Name of Contractor
LaSala °µÍø½ûÇøion
Address of Contractor
1620 Seacliff Drive, Leamington, ON N9Y 2M6
Name of Certifier
SMD Windsor Inc.
Address of Certifier
811 Devonshire Road, Windosr, ON N8Y 2M3

Identification of Premises

Pt 12, Lts 15 & 16, Conc 3, Pt 1, 12R 4669, Colchester South, Essex
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