2. 
4. Solid Waste Services Commercial Curbside Application (Downtown Only)
   For businesses and residential apartments located within the downtown central business district
8. Name of Business / Resident*
9. Business Name As Listed on Occupational Tax Certificate
11. Contact Person*
12. Date of Birth
    Date of Birth
14. Drivers License Number or Last 4 Digits of the Social Security Number
15. Email Address*
19. Location Address
21. Address 1*
23. Address 2
25. City*
26. State*
27. Zip*
31. Mailing Address
33. Address 1*
35. Address 2
37. City*
38. State*
39. Zip*
43. Phone Number*
44. Water Bill Account Number
46. Multiple Units?*

    1. Yes
    2. No
47. How many?
51. How Often Do You Want Your Garbage Collected?*

    1. B: THREE TIMES A WEEK (Not available to bars and restaurants)
       (Monday through Saturday)
       $51.00 per month
       
       
    2. 1A: ONCE A DAY
       (Monday through Sunday)
       $148.25 per month
       
       
    3. 2A: TWICE A DAY
       (Monday through Sunday)
       $289.75 per month
       
       
    4. 3A: MULTIPLE CART/LARGE VOLUMN CURBSIDE SERVICE
       (Monday through Sunday)
       $577.50 per month
       
       

    Note: Businesses serving lunch and dinner are REQUIRED to have a MINIMUM SERVICE LEVEL of 2A

55. RECYCLING SERVICES
    COLLECTION FOR BOTH PAPER AND BOTTLE AND CAN RECYCLING will be the same as garbage collection days and hours.
59. Application Agreement
    By my signature below, I hereby declare that I am an official representative of the business or other entity named above and that I am legally authorized to conduct business for said business or other entity; that the base level of service (number of daily or weekly collections) selected herein is in accordance with the requirements of Section 5-2-11 of the Code of Athens-Clarke County for the type and nature of business or other activity for which I am hereby contracting to have solid waste collected; that I understand the base fee will be due and payable for each month said business or other entity is in operation at the address herein indicated, regardless of the amount of solid waste collected therefrom; that all solid waste produced by said business or other entity will be collected by the Athens-Clarke County Solid Waste Department. Additionally, if I have chosen Curbside Collection that in addition to payment of the monthly base fee, all solid waste generated by said business or other entity, with the exception of materials to be recycled, will only be placed in official Athens-Clarke County garbage bags for curbside collection.
61. Digital Signature*
62. DATE*
    DATE
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit Submit and Print

* indicates a required field