Vacant Property-Trash Exemption Form

I, the undersigned, represent that I own or manage the property listed below, labeled the property subject to this representation; I further represent that no one is currently living at this property and no trash is generated at the property, but I have kept water service to the property; I understand that if any person later occupies the property, myself or the occupant will be subject to the requirements of Section 102-2 of the Code of Ordinances of the City of Springdale, and will be required to pay for residential trash service; I further understand that violation of Section 102-2 of the Code of Ordinances is punishable by a fine of up to $500 per incident; I further understand that Waste Management and Springdale Water Utilities are relying on my representation and will not send me a trash bill pursuant to this representation, but in the event anyone later occupies the property and water service is still in my name, I will notify Waste Management and Springdale Water Utilities, and residential trash service to the property will be resumed; Further, I understand that if water service is transferred to another person's name, residential trash service will be added to that person's water bill.