Multi-Unit Dwelling EV Charging Installation Approval Form
Applicant Information
Applicant Name
Unit Number
Contact Number
Email Address
Property Information
Property Name
Property Address
HOA/Property Manager Name
HOA/Property Manager Contact
Parking Space
Parking Space Number
Parking Type
Assigned
Shared
Personal Garage
Other
EV Charger Details
EV Charger Make & Model
Charger Level
Level 1 (120V)
Level 2 (240V)
Installation Location Description
Installer Information
Installer/Contractor Name
Installer License Number
Installer Contact Info
Supporting Documents
Site Plan / Diagram Reference
Permit/Approval Reference (if any)
Applicant Acknowledgement
I certify the above information is accurate.
Applicant Signature
Date