1 Olde Half Day Road, Lincolnshire, IL 60069
www.lincolnshireil.gov
P: 847-883-8600
F: 847-883-8608
Page 1 of 1
STAMP HERE
DUMPSTER PERMIT APPLICATION
OFFICE USE ONLY
Permit #:
PROJECT INFORMATION
Business/Applicant Name:
Property Address (including lot / suite #):
State:
Zip Code:
Cell:
Fax:
DUMPSTER INFORMATION
Company/Supplier Name:
Name:
Address:
Suite:
City
State:
Zip Code:
Phone:
Cell:
Fax:
Email:
PERIOD OF TIME REQUESTED
7 days
14 days
21 days
28 days
CONDITIONS OF DUMPSTER PERMIT
1. The dumpster must be located entirely on the driveway and out of the right-of-way. Should the Applicant want to
place the dumpster off the drive area and in a turf area, they must first call the Building Inspector to determine
whether or not special precautions need to be taken. Failure to follow this requirement will result in an immediate
Stop-Work Order and the assessment of fines as described in the Village Code.
2. All materials and equipment must be stored only on the paved portion of the driveway. Materials and
equipment may not be stored under the drip line of any trees.
3. A copy of this permit shall be posted at the project site with work is in progress.
4. The roadway shall be kept clear of debris at all times. If the pavement is not cleared by the end of the
day, work may be stopped and, if necessary, the Public Works Department will clean the road. The
Developer will then be charged the Village’s actual cost plus 20%, with a minimum of $500.00 per
occurrence, each time the Village cleans the road.
5. Work hours for outdoor construction are as follows:
Monday - Friday
Saturday
Sunday
7 a.m. – 7 p.m.
8 a.m. – 6 p.m.
No work permitted (except building/grounds maintenance from 10 a.m. - 6 p.m.)
6. At
no time may the dumpster be stored within a Village road and/or right-of-way.
7. Applicant must notify Village when dumpster has been removed.
SUBMITTAL STATEMENT
I, ___________________________, certify that the information contained in this application, attached
plans, and specifications, and other attached documentation is true to the best of my knowledge. I also
recognize that at the permit applicant, all fees and requirements associated with the review and future
approval of the work described herein are my responsibility.
Signature: Date:
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