Application for Commercial Sanitation Service
Date
/
Month
/
Day
Year
Date
Name of Business
*
Address of Business
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a Current City of Dickson Business License?
*
Please Select
Yes
No
Name of Business Owner
*
Business Owner Contact Number
*
Please enter a valid phone number.
Business Owner Email
*
example@example.com
How Would You Like to Receive Invoices?
*
Please Select
By Mail (Please see below)
By Email
Mailing Address for Invoices
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Carts Requested (Maximum of Three Carts)
*
Please Select
1
2
3
Number of Pick Up Days Requested
*
Please Select
One Day A Week
Two Days a Week
Do you need cardboard removal? (Cardboard must be empty, broken down, and placed next to cart.)
*
Please Select
Yes
No
Select a Payment Option
*
Please Select
Monthly
Quarterly
Semi-annually
Annual
City of Dickson Sanitation Policy-As of January 2021
*
Submit
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