Neighborhood Clean Up Application

APPLICATION
NEIGHBORHOOD CLEAN UP
Public Services Office • 1435 S. Washington Avenue • Saginaw Michigan 48601

Completion of this application is required for neighborhood clean ups of City parks, streets, parking lots and other public facilities for special activities and events. This completed application must be submitted the to the Public Services Office within a minimum of 2 weeks (14 days) in advance of the clean up event.
- Civic Groups, Neighborhood Organizations and other groups who participate in the clean up of the street right-of-ways and vacant lots in the City of Saginaw are asked to complete this application and follow the rules in order to allow the City to coordinate its services with the project.
- When placing rubbish, trash, yard waste, and other debris at the curb for pickup by the City's Streets Division, please separate the debris into piles described below to help facilitate a faster and more efficient collection process of the rubbish at the sites of the vacant lots.
- A map of the area where the clean up will take place.
- Pile #1 - Brush and tree parts (limbs no greater than 4 inches in diameter).
- Pile #2 - Yard Waste in Kraft Paper Bags Only. No yard waste is to be placed into plastic bags.
- Pile #3 - Trash and rubbish in plastic bags or approved trash containers.
- No car parts to be placed at the curb.
- No Hazardous Waste to be placed at curb. This includes, but is not limited to:
  - Toxic Materials
  - Motor Oil
  - Paint
  - Solvents
  - Liquids of any kind
  - Car Batteries or batteries of any other kind
Neighborhood Group Information
Group Name
Example: My Neighborhood Association
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Authorized Representative / Contact Name
Example: John Smith
Title, Role or Affiliation
Example: Events Coordinator
Email Address
Example: JohnSmith@MyNeighborhoodAssociation.com
Phone Number
Example: (989) 399-1311Format: (000) 000-0000.
Event Information
Clean Up Location
Date of Clean-Up

MonthDayYear
Estimated Attendance
Start Time

Hour Minutes

AM/PM Option
End Time

Hour Minutes

AM/PM Option
What assistance are you requesting from the City for this event?

Other (please explain)
Map of the clean up area

Cancelof
Applicant Agreement
TODAY

MonthDayYear
I, {authorizedRepresentative}, representative of {groupName}, hereby declare {groupName} as one of the inducements to the City of Saginaw, to appear, defend, and hold the City of Saginaw, its officials, employees and agents harmless as against any and all claims for person injury, bodily injury, or property damage which may arise directly or indirectly from the event described herein, including any and all costs for personal injury, bodily injury, or property damages, for which a claim or demand is asserted, whether such claim is frivolous or made in good faith. Such indemnification shall include any and all costs and expenses including, but not limited to court costs and fees, attorney fees, witness fees, expert fees, damages and interest which may be incurred by or assessed against the City of Saginaw, its employees, officials or agents.

By signing, I declare that the information I have provided is true to the best of my knowledge and I am authorized to submit this application on behalf of {groupName}, dated {today}.
Please fill out all required fields to generate agreement preview.
Signature

Authorized Representative
Should be Empty:

Neighborhood Group Information

Event Information

Applicant Agreement