TOWN OF
APPLICATION FOR
TRANSFER STATION / RECYCLING CENTER DECAL
2007 - 2008
Name: _________________________________________________________________
Local Address: __________________________________________________________
________________________________________________________________________
Local Telephone Number:
_________________________________________________
Check where applicable: Property
Owner Renter
If Renter, Owner’s Name:
_________________________________________________
To Be
Completed By Town Office: Decal
# 1: _______________
Decal
# 2: _______________
Decal
# 3: _______________
Decal
# 4: _______________
|
Item |
Quantity |
Price Each |
Subtotal |
|
Decal # 1 |
1 |
$4.00 |
$4.00 |
|
Additional Decals |
|
$1.00 |
|
|
Postage & Handling |
1 |
$1.00 |
$1.00 |
|
|
TOTAL AMOUNT ENCLOSED |
|
|
Address where decal(s) should be mailed:
Street/PO Box _____________________________________________________
City __________________________________State ______ Zip _____________
Please mail your completed application,
along with your payment, to:
Town of
Center