2. 

   Solid Waste Application

4. Account Number
6. Name
8. Home Phone Number
9. Cell Phone Number
11. Spouse/Co-Occupant
13. Service Address
15. Address
17. City
18. State
19. Zip Code
21. Mailing Address
23. Address
25. City
26. State
27. Zip Code
29. Move In Date
    Move In Date
30. Type of Structure
    -- Select One --Single Family HomeDuplexTownhouseMobile HomeApartmentRVOther (container home, tiny home, etc)
32. Parcel Number
34. Rental Property: My signature certifies that I know this account has been created and I am liable for payment in the event of default by said occupant(s).
36. Property Owner

38. Please include the following with your Solid Waste Application:

    • Renters – include Rental or Lease Agreement
    • Homeowners – include at least 1 of the following documents:

    • Land Deed
    • Electrical Connection Date
    • Certificate of Occupancy
    • Settlement Statement
40. Renters - Upload a copy of the Rental/Lease Agreement

    *A copy of rental/lease agreement must be provided

42. Homeowners-Upload a copy of 1 of the required documents

    *A copy of at least 1 of the required documents must be provided

44. Signature Acknowledgement

    By typing my name above, I certify the information provided is true and correct. 

45. Date
    Date
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field