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2. 
4. PURPOSE OF THIS FORM

   The purpose of this form is to request a temporary suspension of waste and recycling collection services within the City of North College Hill service area. 
   
   NOTE: We may contact you to confirm additional information, or to verify you are authorized to submit this request.

6. Printable PDF Request Form
   CLICK HERE

   If you prefer not to submit the online form, you may also download and print a PDF version of this form, and send it to the Administration Office.

10. REQUESTOR NAME*
12. REQUESTOR EMAIL*
13. REQUESTOR BEST PHONE*
15. REQUESTOR ADDRESS*

    Please include apartment, unit, or suite number, if applicable.

16. REQUESTOR ZIP*
18. SAME AS SERVICE ADDRESS?*

    Is the REQUESTOR address above the same as the SERVICE address for this request?

    1. Yes
    2. No
20. SERVICE ADDRESS

    Please include apartment, unit, or suite number, if applicable.

21. SERVICE ZIP
23. SUSPEND SERVICE ON:*
    SUSPEND SERVICE ON:

    Enter the beginning date of service interruption.

24. RESUME SERVICE ON:*
    RESUME SERVICE ON:

    Enter the date that service should resume.

26. AUTHORIZED SIGNATURE*

    Type your full name to electronically sign this form.

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field