Forms • Additional Garbage Can

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Additional Garbage Can

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What is your first and last name?*

What is the name on the Utilities account? (if different from your name)

What is your street address?*

Are you already an existing Town of Southern Pines customer (water, sewer, trash, or other billed service)?*

Yes

What is your phone number?*

What is your email address?*

Would you like to have two garbage cans collected at your location? For residential customers, an additional $6 will be added to your monthly bill for a total of $31.25 for trash pick-up. For commercial customers, an additional $8.00 will be added to your monthly bill for a total of $35 for trash pick-up.*

Yes

If you answered yes to having two garbage carts collected, do you need a second cart? Carts are available for a $75 one-time charge. Only Town provided cans will be picked up by our vendor. (Answer NO if you already have two Town provided garbage carts)

Yes

Is this a residential or commercial property?*

Residential

Commercial

Do you agree to an additional monthly charge ($6 for residential/$8.00 for commercial) for your second garbage cart? *

Yes

By checking the "I Agree" box below, you agree and acknowledge that 1) you application will not be signed in the sense of a traditional paper document, 2) by signing in this alternative manner, you authorize your electronic signature to be valid and binding upon you to the same force as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. *

Yes