Sign-up Form for Homeowner Refuse Collection

Name

Street Address

Billing Address

City, State, Zip Code

Daytime Phone

Home Phone

Service Level? Pick one... Mini-mini - $11.75/month Mini - $15.25/month One can - $21.75/month Standard - $27.50/month Maxi - $34.00/month View Service Levels

In Yard Collection? Pick one... 300' driveway - $11.50/month longer than 300' driveway - $15.00/month

understand that:

1. I am electing the collection service at the residence indicated above.
2. I agree to pay the fees as set by the Town of Mansfield and agree to abide by the Town’s Solid Waste Ordinance and Regulations.
3. Bills are sent out quarterly in advance of service.
4. Unlimited amounts of recyclables are accepted with collection service.
5. I am responsible for recycling (link will open in new window). Recyclables mixed in the trash may result in the trash not being taken.
6. I am responsible for providing my own can at the right size. Mini service uses a 20 gallon can; one can, standard and maxi services uses 35 gallon cans. Use of larger sized cans may result in trash not being taken.
7. Trash and recyclables should be placed by the road the night before collection.
8. I will receive a confirming phone call to start service.

I understand and agree to the above statements