| THIS APPLICATIONS IS FOR:
_________________________________
(Print Name of Owner or Agent
_________________________________
(Street Address and Job Location)
Village of Spring Lake, Michigan 49546, Ottawa
(Village, State, Zip Code & County)
WHO IS DOING THE WORK:
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(Name of Electrical Firm)
_________________________________
(Signature - Electrician/Homeowner)
_________________________________
(Address)
_________________________________
(City, State, Zip Code)
_________________________________
(State License No.)
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(Telephone No.)
I agree to fully comply with the electrical laws of the State of Michigan.
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