An application is hereby made to permit the placement of a waste refuse container, commonly known as a roll-off dumpster or roll-off container on or along the above listed roadway.

It is agreed that any dumpster or container placed on or along the roadway shall be equipped with markers consisting of yellow reflective panels having a minimum size of eighteen (18) inches by eighteen (18) inches. These reflective panels shall be mounted at the edge of the dumpster or container at both ends nearest the path of passing vehicles and facing the direction of oncoming traffic. These markers shall have a minimum height of three (3) feet from the bottom of the panels to the surface of the roadway. If approved, this permit shall be valid for a period of seven (7) days, and may be renewed by the approving authority for an additional seven (7) day period, but not to exceed more than thirty (30) days.

The applicant is responsible for any damage to the roadway or other property caused by the placement of the dumpster or container.
By entering your Initials and Date you agree to the conditions set forth on this permit application.
 Your Initials     mm/dd/yyyy  Today's Date

PLEASE REVIEW ALL ENTRIES BEFORE SUBMITTING FORM.
PRESSING SUBMIT WILL AUTOMATICALLY SEND FORM.