RE: Sanitation Department Account Number: _____________________________ Service Address: _____________________________ Cart Number: ________________________________
Dear Valued Resident:
Please complete this form and contact the City of Zephyrhills Police Department at 813- 780-0050 to file a report. Failure to return this form within 14 calendar days will result in a one-time fee of $60.00 for the cost of the container, delivery and processing.
Please contact our office for additional information, or if you feel this information is inaccurate.
Shane LeBlanc Public Works Director
Upon completion of this form with a valid police case number, statement and signature, please submit via email to the Public Works Department at firstname.lastname@example.org.
Police Case No: __________________________ Your statement about your cart: