2. VOLUNTARY PROGRAM CANCELLATION

4. Property Address*
5. Utility Account #
7. Type of Service to be Discontinued (check all that apply)*

   1. Curbside Recycling Program
   2. Additional Curbside Recycling Cart
   3. Additional Refuse Cart

   1. Yard Waste Cart
   2. Water Service Repair Program
   3. Sewer Lateral Repair Program
11. Subscriber Name
12. Property Owner Name (if different than subscriber)
14. Subscriber Address
15. Property Owner Address (if different than subscriber)
17. Subscriber Phone Number
18. Property Owner Phone Number (if different than subscriber)
20. The cart will need to be placed at the normal pickup area by Wednesday the following week. Charges will continue for the service until the container has been retrieved by the City.
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit Submit and Print

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