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Certification for Waiver of Sanitation Fees

  1. Must be at least 3 consecutive months.

  2. Acknowledgement*

    I, the owner of the property indicated above, testify and certify that this property will be vacant for a period of not less than 3 consecutive months indicated above. I request that sanitation service changes be waived from the City of Fairmont utility bill rendered for that service location in accordance with Article 937 of the Fairmont City Code. I am furnishing this signed affidavit as a rebuttal of prima facie evidence that benefit is being deprived or that sanitation (solid waste) services are being obtained. I understand that I am responsible for providing an updated certification every 3 months as long as the property remains vacant and that no benefit is being derived from sanitation service.

  3. Leave This Blank:

  4. This field is not part of the form submission.