Application for a Container Licence Privacy Statement The Town is collecting your personal information for the purpose of responding to your request. Some of the information may be provided to the Town's contractors for the purpose of addressing your request. Your information will not be provided to any other person or agency unless you have given us permission, or where legally obligated to do so. If you would like to know more about how the Town handles your personal information, please see the Town's Privacy Statement and Collection Notice. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- For more information about the definition of a container licence and how to place on your verge/carriageway please visit Payment will only be deducted from Credit Card over the phone if the container permit is approved Name*This field is required. * Required Field. Company Name (If Applicable) Residential / Business Address - Address where sea container is to be placed if approved*This field is required. * Required Field. Phone Number*This field is required. * Required Field. Mobile Phone Number*This field is required. * Required Field.* PLease enter a valid mobile phone number Email Address*This field is required. * Required Field.* Please enter a valid email address Size of Sea Container (Cubic Metre)*This field is required. * Required Field. Date container is to be delivered*This field is required. * Required Field. Date container is to be collected*This field is required. * Required Field. If you have a photograph of the area where the sea container is to be placed, please attach it here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Location*This field is required. RoadVerge Signature*This field is required. * Required Field. Date Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image