E-Gov Services City of Bristol

New Refuse Service

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Purpose. This form is used to communicate with city personnel to request refuse services.
After completion of the below form you must bring a photo ID with either a lease agreement or closing statement to City Hall Room #203 in order to activate your service.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
* Email:
* Daytime Phone:	() –
* Address:
* City:
* State:
* ZIP:

* Service Street Address:

* Number of containers: (first container $10 additional containers $5 each)

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.