Authorize

Please use this form to authorize us to install or remove your shoreline equipment.

Name

Address

City

State

Zip

Lake Address

 Email Address

Phone Number

If you need to contact me, I prefer to be contacted by:

e-mail

Phone

Requested Install / Removal Date:

ASAP

Other

2nd Choice

Equipment to be installed / removed

Lift(s)

Dock/pier

Other (explain below)
Do you need any repairs done?

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