Multi-Family Housing Site Type Application

Level 2 Chargers Eligible Only

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Provide site name, Ex. Skyway Library.
Property manager/municipality/tribe

Legal Owner Contact

Name, phone, email for legal owner

Name (Legal Owner)
Has the legal owner agreed to the charger installation and willing to attest to supporting this project? Yes/No

Site Contact Person

Name, phone, email of person managing the installation

Name (Site Contact)
Local utility serving the site
Total number of ports that applicant is seeking funding for (Maximum allowable ports (20)
All sites must have either J1772 or NACS
Number of total parking spaces at site
Number of L2 EV parking spaces to be installed
Indicate commitment to electrician apprentices - the percentage of crew to be apprentices.
Indicate commitment to use MWBE contractor.
Number of stub-outs for Level 2