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August 2023 LICENSE NO. Code Enforcement 7635 Macon Highway • Suite 400 • Watkinsville, Georgia 30677 • [PHONE REDACTED] SOLID WASTE COLLECTION AND DISPOSAL SERVICES LICENSE APPLICATION Application is hereby made by (Name of Applicant) (Business Name) (Business phone number) (P.O. Address) (City, State) (Zip Code) for a license to provide a service for the orderly collection and disposal of municipal solid waste originating in Oconee County. 1) TYPE OF SOLID WASTE COLLECTION AND DISPOSAL SERVICE: a) Residential Service (Check all that apply) b) Commercial Service c) Construction & Demolition Service 2) I have a valid Georgia Department of Natural Resources Environmental Yes Protection Division Solid Waste Resources Handling Permit. (Provide a copy) No_ 3) I have obtained and read a copy of the Solid Waste Collection and Disposal Yes Services Ordinance and agree to comply with all provisions therein, including No_ the indemnification of Oconee County. 4) Required Insurance Certificate provided. Yes No_ 5) Fidelity Bond, and Performance Bond or Letters of Credit provided. Yes No_ Permit requested this day of , 20 . (Renewable in January) By:_ Title: (If agent or official for applicant) FORM TO BE COMPLETED BELOW THIS LINE BY COUNTY OFFICIALS PERMIT License Fee $500.00 Specifications: EPD Permit No. Valid Insurance Certificate Provided Performance Bond Amount $ Fidelity Bond Amount $ Letter of Credit $ Fidelity Performance yes no Amount of Bond $ Insurance Certificate Requirement yes no This application has been reviewed by: Code Enforcement Director/Building Official The above application is approved / disapproved this day of , 20 . BY: Chairman Oconee County Board of Commissioners NOTE: This permit is to be strictly construed and no work other than specifically authorized herein is authorized. This permit must be renewed every January.