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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:

Expected date of completion:

Site plan number:

Number of units:

Number of floors:

Comments:

Personal information provided to the Regional Municipality of Durham is only used for the purposes of processing your application. The information collected is subject to and handled in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Questions about this collection may be directed to the Access and Privacy Office by email at foi@durham.ca; by mail at 605 Rossland Road East, Whitby, ON, L1N 6A3; or by telephone at 905-668-7711, extension 2204 (for FOI information only). If you require assistance with this form, please contact 311 (within Regional limits) or 1-800-372-1102.

Please review the Region of Durham’s Terms of Use and Privacy Statement for more information.