BUCKINGHAM COUNTY

APPLICATION FOR SOLID WASTE PERMIT 

Please email this to jlann@co.buckingham.state.va.us or print off and mail to
Solid Waste Department
13360 James Anderson Highway / P.O. Box 252
Buckingham, VA 23921

NAME: __________________________________________________________

PERMANENT ADDRESS:   ________________________________________

       (where you live)                  ________________________________________

                                                  ________________________________________                                        

PHONE NUMBER: ________________________________________________ 

BUCKINGHAM COUNTY PROPERTY ADDRESS: 

                         _________________________________________

                        _________________________________________

                        _________________________________________

NAME TAX BILL COMES IN: ______________________________________ 

NUMBER OF ACRES: ________  TAX MAP #_____________ 

REASON PERMIT IS NEEDED:

_______ OWN LAND IN COUNTY BUT LIVE SOMEWHERE ELSE

_______  TAKE TRASH OFF FOR A RELATIVE (MUST BE A RELATIVE THAT DOES NOT    DRIVE)

_______  DRIVE COMPANY VEHICLE

_______  OTHER (EXPLAIN: ___________________________________________

                                                     ___________________________________________

__________   FARM USE  (SEE BELOW) 

FARM USE LICENSES MUST BE REGISTERED WITH DMV

             You must file Farm Taxes with the IRS to qualify.______

          FARM ID #: _______________________________________________

         INSURANCE CARRIER______________________________________

        (FARM ID # MUST BE GIVEN IN ORDER TO GET PERMIT) 

ONLY 2 VEHICLES ARE ALLOWED PER LANDOWNER. 

DESCRIPTION OF VEHCILES:

MAKE  MODEL  COLOR LICENSE PLATE______ 

1.____________________________________________________________________

2.____________________________________________________________________ 

ANY QUESTIONS, PLEASE CALL (434) 969-4242 or email jlann@co.buckingham.state.va.us.