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Application for Continuation of Curbside Solid Waste Collection The Fiscal Year 2008 budget for the City of Lewiston changed the manner with which solid waste collection services will be provided to some properties. The City Council approved a measure whereby multiple unit apartment buildings with three or more dwelling units will only receive City provided solid waste collection services if the owner of the building applies for continued service, and agrees to pay $170.00 per unit per year for this service. The amendment to the ordinance includes owner-occupied apartment buildings and separate buildings on the same parcel of land whereby the total units exceed two units. The only exemption from this fee is for three unit, owner occupied buildings. The owner must establish and maintain residency to be eligible for this exemption. This fee will be billed and paid annually in advance, with the first payment due at the time of application or by the end of July, each year. This service is not available to buildings not receiving these services from the City as of May 6, 2003. Please print or type the following information: Name of Owner: Doing Business As: Mailing Address of Owner: Phone Number of Owner: Agent or Property Management Information (Billing address if different from above): Name: Mailing Address: Phone Number: Street address where continued solid waste collection is requested: Number of units or apartments at this address: Annual billed amount for waste collection: I, understand by applying for continued waste collection services (NAME OF OWNER OR AGENT) from the City of Lewiston, this building will continue to receive these services. I agree to pay $170 per apartment (dwelling unit) per year for this service which will be billed to me on an annual basis. Attached to this application is payment for the one-time application fee of $100.00 plus the first annual (prorated where applicable) payment. I understand if I fail to pay for this service on time when the bill is sent, the service will be terminated and there will be no opportunity to reinstate this service. I understand the rate charged will be reviewed annually and adjustments may be made to cover the cost of this service. Further, I also understand that I, as the owner/agent for the above referenced property, am responsible for complying with the City of Lewiston’s Solid Waste Ordinance, Chapter 62. Compliance includes, but is not limited to, setting enclosed solid waste at the curb within the permitted time; acknowledging responsibility and liability for ---PAGE BREAK--- Solid Waste Application Page Two solid waste found at the above referenced location; and encouraging tenants at the above referenced location to recycle their solid waste within the prescribed guidelines. Further, if I wish to terminate the solid waste collection services, I will notify the City of Lewiston’s Accounting Division immediately. If termination of services results from the sale of the building, I will notify the City of Lewiston’s Accounting Division of the effective date of said sale and the name of the new owner. Further, any remaining services due to me after the sale will be settled as part of closing costs, not as a refund from the City of Lewiston. By paying the one time $100 application fee, I understand that I am eligible to receive up to three false or nuisance fire and police calls for free, in a one year period; ten (10) free police report verifications in a one year period; and one free City of Lewiston punch pass for every three dwelling units I own. Date: SIGNATURE OF OWNER OR AGENT Application reviewed and approved by: Deputy Finance Director: Administrative Information: Customer Number: Service Commencement Date: Annual Amount: Application Fee: Total Deposit: Treasurer’s Receipt # of Punch Passes Given: