2023 WASTE FACILITY PERMIT

NAME ____________________________________________________________

ADDRESS ____________________________________________________________

CITY/STATE/ZIP ____________________________________________________________

PHONE NUMBER ____________________________________________________________

EACH PERMIT IS $70.00 PER YEAR IF PURCHASED BY JANUARY 31, 2023

PERMITS ISSUED AFTER JANUARY 31, 2023- $80.00

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FOR TOWNSHIP RECORDING:

DATE _________

WASTE PERMIT NUMBER _________

PAID BY ________________________________________________

CASH $ __________ CHECK # _____________ AMOUNT $_________

OTHER PERMIT # ON SAME CHECK ______________ ______________

PLEASE MAKE CHECKS PAYABLE TO NORTH HANOVER TOWNSHIP AND EITHER HAND DELIVER OR MAIL TO THE ABOVE ADDRESS ATTN: WASTE FACILITY PERMIT.