SUITE 1, LEVEL 2
1-17 ELSIE STREET, BURWOOD, NSW 2134
PO BOX 240, BURWOOD NSW 1805
TEL: 9911 9911 FAX: 9911 9900
WEBSITE: www.burwood.nsw.gov.au
RESIDENTIAL PREMISES – WASTE APPLICATION FORM 2015/2016
Applicant’s Name: ………………………………………………………………... Tel: …………………………………
Bin Service Address: ………………………………………………………………......................................................
If you are not the owner you will need owner’s consent
Note: It is the responsibility of the owner to advise Council if and when the service is to be terminated. Failure
to do so will render the owner liable for any subsequent annual / periodical services billed.
OWNER’S CONSENT COMPULSORY
I ……………………………………... am the owner of the subject property and accept responsibility for the
payment of this and any future accounts issued in accordance with this request for waste services.
Address: ………………………………………………………………...…………………………………………………
Tel: …………………………………. Date: …… / …… / ……… Signature: ………………………………………..
BINS ARE TO BE PAID FOR BEFORE DELIVERY. FURTHER CHARGES WILL THEN BE MADE ON THE
ANNUAL RATE NOTICE.
STANDARD WASTE SERVICE:

Residential Properties

Recycle Bin

Town House Or Villa

1 x 240ltr Recycle Bin

Strata Units

1 x 240ltr Recycle Bin
please tick
1 X 120ltr MGB
1 x 240ltr
1 X 120ltr MGB
$
367.00
30.58
367.00
30.58
367.00
30.58
(weekly)
(fortnightly) per month
(weekly)
(fortnightly) per month
½ X 240ltr MGB or equivalent (weekly)
(fortnightly) per month
NEW STRATA: PAYMENT IS REQUIRED IN ADVANCE FOR SERVICES FOR ALL UNITS PRIOR TO
DELIVERY OF BINS.
ADDITIONAL GARBAGE BINS: please tick
$

Additional
1 X 120ltr MGB (1 service per week on normal day service)
590.00

Per month or part thereof
49.16

Additional
1 X 240ltr MGB residential flat building only
690.00

Per month or part thereof
57.50

Additional
1 X 660ltr MGB
1,520.00

Per month or part thereof
126.66
ADDITIONAL RECYCLING BINS: please tick

Additional
1 X 240ltr Recycle

Additional
1 X 240ltr Recycle
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Residential Premises – Waste Application Form 2015/2016
(fortnightly collection)
(fortnightly collection) per quarter
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$
115.00
28.75
ADDITIONAL GREEN WASTE BINS: please tick

Additional
1 X 240ltr Green Waste (fortnightly collection)

Additional
1 X 240ltr Green Waste(fortnightly collection) per quarter
ADDITIONAL COLLECTION SERVICE - ONE OFF: please tick

Additional
1 x 120ltr service
(per service)
$
120.00
30.00
$
38.00
OFFICE USE ONLY
Ass #: ………………… Receipt #: …………………... Date: …… / …… / …….. Cashier: ………………......
Amount $: ……………. Parcel #: ……………………. Request #: ……………… Bin #: ……………………..
Del Date: …… / …… / ……..
CSO: ……………………………………………………
PRIVACY STATEMENT
If you are applying for consent as an individual, you may be providing Council with personal
information (such as your name and address) within the meaning of the Privacy and Personal
Information Protection Act 1998.
You are obliged by law to provide your name and address. If you do not provide the personal
information requested Council may be unable to process your application.
Council is collecting this personal information from you in order to identify and process your
application.
You may make application for access or amendment to information held by Council. You may also
make a request that Council suppress your personal information from being made publicly available.
Council will consider any such application in accordance with the relevant legislation.
Enquiries concerning this matter can be addressed to Council’s Public Officer.
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