Dumpster/Pod Permit Application

Property Details

Property Owner Name
Property Address

Provider Details


Dumpster Details

Do You Have a Driveway
Installation & Removal Dates (From)
Installation & Removal Dates (TO:)
I hereby Certify that the statements contained herein are true and correct to the best of my knowledge and belief. I understand that if I knowingly make any false statement herein, I am subject to possible revocation of any permit issued as a result of my false application and such other penalties as may be prescribed by law

I, We, as the Property Owner(s) listed above intending to be legally bound, promise to indemnify, save harmless and defend the Borough, its officials, agents, servants, and employees and each of them, against and hold it and them harmless from any and all lawsuits, claims demands, liabilities, losses and expenses, including court costs and reasonable attorneys’ fees for or on account of any injury to any person or any damage to any property including the waste dumpster/POD Storage which may arise or which may be alleged to have arisen out of or in connection with the placement or utilization of a waste dumpster and/or storage on as street within the Borough.
Please type your full name above to serve as your electronic signature