Form Center

2. **We recommend that applicants use Chrome, Firefox, or Internet Explorer 10 or higher.**
4. 
6. Today's Date*
   Today's Date
7. Permit Holder*
8. Permit Number*
10. Township*
11. Beginning Date*
    Beginning Date
12. Submitted By*
14. Title*
15. Phone Number*
16. Location of Work*
18. Description of Work*
20. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
22. Electronic Signature*
24. Note
    - If there is any change in date or time, please notify the permit inspector immediately.
    - All permits require a WRITTEN two day advance notice be submitted before work can begin in the right of way, to allow the finalized permit file to reach the inspector, and for the inspector to coordinate the work into his schedule. The WRITTEN Start of Work form can be filled out and submitted at time of permit issuance, via fax to (248) 858-4773 or email to permits@rcoc.org. Any deviation from the two day advance notice requirement must have prior approval from the Permit Engineer.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field