Application for Local Law Permit - Skip Bin Containers Please fill in and submit this application form to place a Skip Bin on council land. Once you submit this form, a Council Officer will contact you to discuss the relevant permit requirementsName(Required) First Last Organisation Name(Required) Name ABN Postal Address(Required) Street Address Town / Suburb Postcode Primary Contact Number(Required)Secondary Contact NumberEmail(Required) Address Skip Bin is servicing:(if different from above) Street Address Town / Suburb Postcode Proposed Skip Bin site:(Required) On roadway On nature strip In rear of way Other Skip Bin Size (Cubic Metres)(Required)Number of proposed bins(Required)Placement Date(Required) DD slash MM slash YYYY Collection Date(Required) DD slash MM slash YYYY Main type of waste to be collected(Required) Household renovation Household garden waste Building/construction Commercial Industrial Household other Effective from 1/7/22 (subject to change each financial year) 1 – 7 Day Period - $83 7 – 14 Day Period - $83 15 Days + (max 6 months) - $250 Contractor Details(Required) Name Phone number Contractor Email(Required) Public Liability Insurance Certificate of Currency(Required)Max. file size: 128 MB.Please provide a copy of the contractors Public Liability Insurance Certificate of Currency with this application. (Insured for $20 million) Declaration(Required) I/We understand that Council at its discretion may release details contained in this application to adjoining landholders and, if issued, that this permit may become a public document. I/We declare that the information that I/we have supplied in this form, and any attachments to this form, are true and correct to the best of my/our knowledge.Signature(Required) Reset signature Signature locked. Reset to sign again Privacy Statement If you do not wish for us to update our records with the information provided, please check this box.