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Application for Rubbish Service

  1. ex. 12-99-999-999

  2. xxx-xxx-xxxx

  3. Not being a tax supported service, I understand the rate I will be charged is the current rubbish rate, with a late charge of 10% if not paid by the due date indicated on the bill. All regulations and rates are subject to changes as the Contract or Landfill requirements change. Customers will be notified by newspaper or letter.

  4. Find your street name on the Rubbish Pick Up Map.

  5. Indicate which carts you need. These carts will then be delivered to your home within three (3) business days of reciept of this form.

  6. Leave This Blank:

  7. This field is not part of the form submission.



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