Application for Waste Exemption for Medical Reasons

This confidential application is for the City of Cornwall residents who may need to set out more than the limit of garbage bags/cans per week due to a medical condition. Residents must live within a single family home or in an apartment building with six (6) units or less and currently receive curbside collection provided by the City of Cornwall.

Check the boxes if...

this is a renewal application

tags are not required at this time

First and last name of person responsible:

Address:

Municipality/city:

Postal code:

Telephone number:

Email:

Collection day (day of the week in which garbage is collected):

If your application is approved, you will be given special stickers to place on your extra bag(s). Stickers can be picked up from the City of Cornwall Waste Management Department, 861 Second Street West, Cornwall between 8:00 am and 4:00 pm Monday through Friday, or mailed directly to your home.

Would you like to pick up your stickers or have them mailed to you?

Are you completing this application on behalf of another resident with a medical condition?

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Application for Waste Exemption for Medical Reasons