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Waste Collection Service on Private Property and Indemnification Application

The undersigned requests the extended "on site waste collection services on private property" as provided by the The Regional Municipality of Durham.

Upon completion of form, applicant will be contacted by the Region.

Applicant details

Applicant:

Phone number:

Email:

Collection requested at:

Name of property:

Property address:

Contact at property:

Details of locations:

Type of building:

Expected date of completion:

Site plan number:

Number of units:

Number of floors:

Comments:

Personal information is collected and distributed under the authority and in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and is only used for the purposes authorized.