Residential Vehicle Registration Form - Town Of Greenwich Page 2
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1
2Town of Greenwich
Signature required
Department of Public Works, Waste Disposal Division
Type online, print & sign
Holly Hill Resource Recovery Facility, Holly Hill Rd., Greenwich, CT 06830
Phone 203-869-6910 - Fax 203-618-0653
Residential Vehicle Registration Form
The Vehicle Registration Form is maintained by the Town of Greenwich to ensure that only residents of the Town of
Greenwich use the Holly Hill Resource Recovery Facility.
Name __________________________________________________________________________________________________________
Last
First
MI
Address________________________________________________________________________________________________________
Street
City/Town
State
Zip Code
Driver's License No. _____________________________________________________________________________________________
Vehicle Plate No.________________________________________________________________________________________________
State __________________________________________________________________________________________________________
If other than CT, you must prove your residency / local business ownership.
Class:
Passenger
Combination
Camper
Trailer
Vehicle Make ______________________________________
Vehicle Year ___________________________________________
Vehicle Model _____________________________________
Vehicle Color ___________________________________________
I certify that the information I provided is correct and that I am a resident or small business owner in the Town of
Greenwich; and that I will only use this permit to dispose of waste generated within the corporate limits of the town of
Greenwich.
Applicant's Signature: __________________________________________________________
Date________________________
Telephone No. _________________________________________________________________
TO BE COMPLETED BY TOWN OF GREENWICH PERSONNEL:
1. Has driver's license been checked?
YES
NO
2. Has vehicle registration been checked?
YES
NO
3. Does vehicle fit the identification?
YES
NO
4. Initials __________________________________________
REG. No. _______________
TARE WEIGHT _________LBS.
Bring the vehicle you are registering and all proof documents,
then drive ON the scale.
PwWAResVehRegis
Issued 10/2002
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