Karn Solar Project Notification of Complaint Form

Thank you for contacting Consumers Energy regarding an issue, comment, question or concern involving the operation or maintenance of the Consumers Energy Karn Solar Energy Center. The Notification/Complaint Form has been pursuant to requirements for submittal of issues, comments, questions or concerns. Please complete the requested information in as much detail as possible.

Following receipt of the form by Consumers Energy, you will receive an acknowledgement within ten (10) calendar days that includes information on how your issue will be addressed.

PLEASE NOTE: Consumers Energy and/or its authorized agent may need access to your property or residence to fully investigate the complaint. Failure to allow access within a timely manner or at all may affect the resolution of the complaint.

First Name Date of Notification Street Address State Phone Number

Last Name City Zipcode Email Address

Location where event/occurrence happened (if different from above):

Street Address State

City Zipcode

Description of event or occurrence

Date of occurrence Time of Occurrence

Duration of Occurrence

If known, briefly describe how you believe the event or occurrence violates the Township Zoning Ordinance and/or the Special Land Use Permit, such as noise, etc.

By signing below, I attest that I am the owner or other resident of the property and hereby grant Consumers Energy and/or its agents or contractors permission to enter upon above described property for purpose of investigating the event or occurrence described above, after prior notification to me.

Signature ( Please type your name )