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2. Request for Additional Trash/Recyling Cart

   To request an additional trash or recycling cart, please fill out the form below. Please note that accounts with extra bins will be subject to additional charges. 

   The current cost of one additional cart is $5.52 per month. 

6. Account Information
8. Address*
10. Phone Number*
11. Email Address*
13. Account Number

    Enter the account number from your bill for the account that you wish to add extra carts.

15. Route Number*
16. Service Address ID*
17. Resident Number*
19. Additional Cart(s) Authorization
21. Additional Trash Carts Requested
    -- Select One --NONE12345678910
22. Additional Recycling Carts Requested
    -- Select One --NONE12345678910
24. Requested Service Date*
    Requested Service Date
26. Authorization of Services*

    I am the owner of this account and I am requesting additional trash and/or recycling carts for this account. I agree to pay the additional fees for the requested number of carts. The current cost of one additional cart is $5.52 per month and will be charged to the resident's monthly utility bill.

    1. Yes, I agree to the above statement and agree to pay the required fees for the additional carts.
28. Name of the Account Holder*
29. Date*
    Date
33. Upon completion and submittal of you application for a disconnection of services, you will be returned to the Utility Billing page for the Town of Northlake's website. Please contact Utility Billing with any questions or concerns.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field