Property Owner/Manager Permission – Livermore Sanitation

Property Owner/Manager Permission

*Required

If you are unable to complete or submit this form, please call us at 925-449-7300.

To request Property Owner / Manager Permission complete all the required information below and submit.

Date: *

Site address: *

Address Line 1

City

State

Zip Code

APN or account number: *

Property owner name: *

First

Last

Property owner's address: *

Address Line 1

City

State

Zip Code

Phone number: *

Email: *

Management company or other designated representative name:

Management company or other designated representative's address:

Address Line 1

City

State

Zip Code

Management company or other designated representative's phone:

Management company or other designated representative's email:

Permission is granted for the following (check all that apply):

Inquiry on account (service level, balance due, etc)
Report of occupancy change
Service level change

Submission of this form shall serve as your signature: *

I acknowledge the above statement (please check box to continue)

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