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KERBSIDE SERVICE - APPLICATION FORM
REFUSE and RECYCLE WHEELIE BINS
CHARGES P/A: REFUSE 140L = $46.70, 240L = $80.10 RECYCLING 140L = $52.80, 240L = $86.10
Address: Phone:
Applicant Details
Section 1
Contact Name: Mobile
Business Name (if applicable): Fax
email
Please indicate your Application Type: NEW UPGRADE DOWNGRADE REMOVAL
CRITERIA FOR 240L BIN: Families consisting of Five (5) or more permanent residents in a household may apply for a 240L Bin
for refuse Medicare Card to be sighted. Upgrade recycling services available for all households. Section 4 must be completed.
REFUSE RECYCLING
Service Type
Section 2
140L 240L 140L 240L
NEW SERVICE (Council Standard Service is 140L)
UPGRADE / DOWNGRADE
REMOVAL
Business Private
Please indicate the type of PROPERTY this Wheelie Bin Application is for Activities Household
Property Details
Section 3
Are you the OWNER of the property for which this application pertains? Yes No
If you are moving into new premises, has the FINAL BUILDING INSPECTION or
Yes No
OCCUPANCY PERMIT/CERTIFICATE been completed?
240Litre Applicants Only (Excluding Commercial Applicants)
Number of ADULTS permanently residing in household
Upgrade details
Number of CHILDREN permanently residing in household
Section 4
Other reasons a 240L bin may be required:
MEDICARE CARD sighted - Office use only Yes No
Signature of Applicant
Signature
Date / /
Please Note This Important Information
Council advises that all residential households will be charged a Waste Management, Recycling, and Green Waste Rate, including
Information
those residents who choose to have any or all of these services removed from their property.
Important
Council's services will not accept toxic or hazardous wastes, commercial food wastes, or materials which may damage bins or the
collection vehicles.
By signing this form you undertake to notify Council of any change to the facts stated within this form.
Properties used for Business Activities or in excess of standard service attract a 10% Goods and Services Tax (GST).
OFFICE USE ONLY
APPROVAL
APPLICATION: Approved / Not Approved
.........................................................
Waste Management Co-ordinator
NOTIFICATION DATE
Veolia Environmental Services Faxed /Emailed YES NO N/A
Letter sent to property owner (refer Section 3) YES NO N/A
Finance Program YES NO N/A
TECH-ONE updated YES NO N/A
Final Building inspection or occupancy Cert Completed YES NO N/A
Date Delivered YES NO N/A
***Note:
All zeros before a bin number are excluded from the actual bin number, for example bin number
000025 is in fact number 25.
240L Wheelie Bins have the prefix 240 before the rest of the bin number, for example a 240 litre
the number 000356 becomes 240356
Personal Information Protection Statement
The personal information that Council is collecting from you is deemed personal information for
the purposes of the Personal Information Protection Act 2004.
The intended recipients of personal information collected by Glenorchy City Council may be:
Officers within Glenorchy City Council;
Data service providers engaged by Council from time to time;
Any other agent/contractor of Glenorchy City Council.
The supply of the information by you is voluntary. If you cannot provide or do not wish to
provide the information sought, Glenorchy City Council may be unable to process your
application or request.
Council is collecting this personal information from you for the purposes of managing, assessing,
advising upon and determining the relevant application, or other Council related matters.
You may make application for access or amendment to your personal information held by
Council.
Enquiries concerning this matter can be addressed to Freedom of Information Officer,
Glenorchy City Council, PO Box 103, Glenorchy, 7010 Phone: 6216 6700
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