POTTSTOWN POLICE DEPARTMENT
100 East High Street
Pottstown, P L 19 464-9525
APPLICATION TO BLOCK PARKING SPACES FOR
TRASII DUMPSTER/WASTE CONTAINEWBAGSTER /Etc.
Date:
Applicants Name:
Address:
Business Phone:
Phone:
Exact Location of Placement of Container:
(Cannot be within 75' ofan intersection
Number of days container will be at site:
FEES:
Beginning on:
:
$
4.00 per day X number of daYs
15 Yards
$
5.50 per day X number
16 to 20 Yards
$
8.00 perday X number ofdaYs
:
2l
$12.00 per day X number of daYs
:
$20.00 per day X number of daYs
:
Up to 10 Yards
11
to
to 30 Yards
31 + Yards
Temporary No Parking Signs
$
ofdaYs:
2.00 each X number of signs =
TOTAL DUE
Applicants Signature:
ttlaltrllalal'lll'lrlllr
APPROVED
Code: 0l-363-022.10
DISAPPROVED
Date
Authorizing Police Official
-
including alleys)