{"id":14629,"date":"2015-04-30T09:34:47","date_gmt":"2015-04-30T13:34:47","guid":{"rendered":"https:\/\/cswd.net\/?page_id=14629"},"modified":"2020-09-18T13:17:29","modified_gmt":"2020-09-18T17:17:29","slug":"hauler-license-application","status":"publish","type":"page","link":"https:\/\/cswd.net\/forms-publications\/hauler-license-application\/","title":{"rendered":"Hauler License Application (Online)"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_112' style='display:none'><div id='gf_112' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Hauler License Application <\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_112'  action='\/wp-json\/wp\/v2\/pages\/14629#gf_112' data-formid='112' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_112' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_112_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_112' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_112_13\" class=\"gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_13\" ><label class='gfield_label gform-field-label' for='input_112_13'>Business Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_112_13' type='text' value='' class='medium'     aria-required=\"true\" required aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_2\" class=\"gfield gfield--type-name gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_2\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Owner&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_112_2'>\n                            \n                            <span id='input_112_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_112_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_112_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_112_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_112_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_112_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/li><li id=\"field_112_124\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_124\" ><label class='gfield_label gform-field-label' for='input_112_124'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_124' id='input_112_124' type='tel' value='' class='medium'   aria-required=\"true\" required aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_112_125\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_125\" ><label class='gfield_label gform-field-label' for='input_112_125'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_125' id='input_112_125' type='email' value='' class='medium'    aria-required=\"true\" required aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_112_3\" class=\"gfield gfield--type-address gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_3\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_112_3' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_112_3_1_container' >\n                                        <input type='text' name='input_3.1' id='input_112_3_1' value=''    aria-required='true'    \/>\n                                        <label for='input_112_3_1' id='input_112_3_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_112_3_2_container' >\n                                        <input type='text' name='input_3.2' id='input_112_3_2' value=''     aria-required='false'   \/>\n                                        <label for='input_112_3_2' id='input_112_3_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_112_3_3_container' >\n                                    <input type='text' name='input_3.3' id='input_112_3_3' value=''    aria-required='true'    \/>\n                                    <label for='input_112_3_3' id='input_112_3_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_112_3_4_container' >\n                                        <input type='text' name='input_3.4' id='input_112_3_4' value=''      aria-required='true'    \/>\n                                        <label for='input_112_3_4' id='input_112_3_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_112_3_5_container' >\n                                    <input type='text' name='input_3.5' id='input_112_3_5' value=''    aria-required='true'    \/>\n                                    <label for='input_112_3_5' id='input_112_3_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_3.6' id='input_112_3_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/li><li id=\"field_112_99\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_99\" ><label class='gfield_label gform-field-label' >Are your mailing and business addresses the same?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_112_99'>\n\t\t\t<li class='gchoice gchoice_112_99_0'>\n\t\t\t\t<input name='input_99' type='radio' value='Yes'  id='choice_112_99_0'    \/>\n\t\t\t\t<label for='choice_112_99_0' id='label_112_99_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_112_99_1'>\n\t\t\t\t<input name='input_99' type='radio' value='No'  id='choice_112_99_1'    \/>\n\t\t\t\t<label for='choice_112_99_1' id='label_112_99_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_4\" class=\"gfield gfield--type-address gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_4\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Business Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_112_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_112_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_112_4_1' value=''    aria-required='true'    \/>\n                                        <label for='input_112_4_1' id='input_112_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_112_4_2_container' >\n                                        <input type='text' name='input_4.2' id='input_112_4_2' value=''     aria-required='false'   \/>\n                                        <label for='input_112_4_2' id='input_112_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_112_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_112_4_3' value=''    aria-required='true'    \/>\n                                    <label for='input_112_4_3' id='input_112_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_112_4_4_container' >\n                                        <input type='text' name='input_4.4' id='input_112_4_4' value=''      aria-required='true'    \/>\n                                        <label for='input_112_4_4' id='input_112_4_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_112_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_112_4_5' value=''    aria-required='true'    \/>\n                                    <label for='input_112_4_5' id='input_112_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_112_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/li><li id=\"field_112_12\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_12\" ><hr>\n<h2>Local Contact Information<\/h2><\/li><li id=\"field_112_6\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_6\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Local Contact Person<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_6'>Note: This is the person authorized by the owner to receive all communications regarding the hauler's license.<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_112_6'>\n                            \n                            <span id='input_112_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.3' id='input_112_6_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_112_6_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_112_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.6' id='input_112_6_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_112_6_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/li><li id=\"field_112_7\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_7\" ><label class='gfield_label gform-field-label' for='input_112_7'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_112_7' type='email' value='' class='medium'    aria-required=\"true\" required aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_112_8\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_8\" ><label class='gfield_label gform-field-label' for='input_112_8'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_112_8' type='tel' value='' class='medium'   aria-required=\"true\" required aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_112_14\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_14\" ><hr><\/li><li id=\"field_112_9\" class=\"gfield gfield--type-number field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_9\" ><label class='gfield_label gform-field-label' for='input_112_9'>Number of Residential Customers<\/label><div class='ginput_container ginput_container_number'><input name='input_9' id='input_112_9' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\" aria-describedby=\"gfield_description_112_9\" \/><\/div><div class='gfield_description' id='gfield_description_112_9'>Please enter a whole number.<\/div><\/li><li id=\"field_112_10\" class=\"gfield gfield--type-number field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_10\" ><label class='gfield_label gform-field-label' for='input_112_10'>Number of Commercial Customers<\/label><div class='ginput_container ginput_container_number'><input name='input_10' id='input_112_10' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\" aria-describedby=\"gfield_description_112_10\" \/><\/div><div class='gfield_description' id='gfield_description_112_10'>Please enter a whole number.<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_112_16' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"2\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"2\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_112_2' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_112_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_112_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_4col gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_17\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Solid waste to be transported is generated in:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_17'>Check all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_17'><li class='gchoice gchoice_112_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='Entire District'  id='choice_112_17_1'   aria-describedby=\"gfield_description_112_17\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_1' id='label_112_17_1' class='gform-field-label gform-field-label--type-inline'>Entire District<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='Bolton'  id='choice_112_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_2' id='label_112_17_2' class='gform-field-label gform-field-label--type-inline'>Bolton<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.3' type='checkbox'  value='Burlington'  id='choice_112_17_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_3' id='label_112_17_3' class='gform-field-label gform-field-label--type-inline'>Burlington<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.4' type='checkbox'  value='Charlotte'  id='choice_112_17_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_4' id='label_112_17_4' class='gform-field-label gform-field-label--type-inline'>Charlotte<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.5' type='checkbox'  value='Colchester'  id='choice_112_17_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_5' id='label_112_17_5' class='gform-field-label gform-field-label--type-inline'>Colchester<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.6' type='checkbox'  value='Essex'  id='choice_112_17_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_6' id='label_112_17_6' class='gform-field-label gform-field-label--type-inline'>Essex<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.7' type='checkbox'  value='Essex Jct.'  id='choice_112_17_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_7' id='label_112_17_7' class='gform-field-label gform-field-label--type-inline'>Essex Jct.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.8' type='checkbox'  value='Hinesburg'  id='choice_112_17_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_8' id='label_112_17_8' class='gform-field-label gform-field-label--type-inline'>Hinesburg<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.9' type='checkbox'  value='Huntington'  id='choice_112_17_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_9' id='label_112_17_9' class='gform-field-label gform-field-label--type-inline'>Huntington<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.11' type='checkbox'  value='Jericho'  id='choice_112_17_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_11' id='label_112_17_11' class='gform-field-label gform-field-label--type-inline'>Jericho<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.12' type='checkbox'  value='Milton'  id='choice_112_17_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_12' id='label_112_17_12' class='gform-field-label gform-field-label--type-inline'>Milton<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.13' type='checkbox'  value='Richmond'  id='choice_112_17_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_13' id='label_112_17_13' class='gform-field-label gform-field-label--type-inline'>Richmond<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.14' type='checkbox'  value='Shelburne'  id='choice_112_17_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_14' id='label_112_17_14' class='gform-field-label gform-field-label--type-inline'>Shelburne<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.15' type='checkbox'  value='South Burlington'  id='choice_112_17_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_15' id='label_112_17_15' class='gform-field-label gform-field-label--type-inline'>South Burlington<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.16' type='checkbox'  value='St. George'  id='choice_112_17_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_16' id='label_112_17_16' class='gform-field-label gform-field-label--type-inline'>St. George<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.17' type='checkbox'  value='Underhill'  id='choice_112_17_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_17' id='label_112_17_17' class='gform-field-label gform-field-label--type-inline'>Underhill<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.18' type='checkbox'  value='Westford'  id='choice_112_17_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_18' id='label_112_17_18' class='gform-field-label gform-field-label--type-inline'>Westford<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.19' type='checkbox'  value='Williston'  id='choice_112_17_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_19' id='label_112_17_19' class='gform-field-label gform-field-label--type-inline'>Williston<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.21' type='checkbox'  value='Winooski'  id='choice_112_17_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_21' id='label_112_17_21' class='gform-field-label gform-field-label--type-inline'>Winooski<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_17_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.22' type='checkbox'  value='Outside of CSWD'  id='choice_112_17_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_17_22' id='label_112_17_22' class='gform-field-label gform-field-label--type-inline'>Outside of CSWD<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_18\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_18\" ><label class='gfield_label gform-field-label' for='input_112_18'>Specify solid waste districts served outside of CSWD<\/label><div class='gfield_description' id='gfield_description_112_18'>Please separate multiple districts with a comma.<\/div><div class='ginput_container ginput_container_text'><input name='input_18' id='input_112_18' type='text' value='' class='medium'  aria-describedby=\"gfield_description_112_18\"    aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_39\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_39\" ><h2>Vehicle Information<\/h2>\n1. Complete the Vehicle Information Table below, or upload your own file containing the requested information.<br>\n2. Upload your proof of insurance.<\/li><li id=\"field_112_123\" class=\"gfield gfield--type-list field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_123\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >1. Vehicle Information Table<\/label><div class='gfield_description' id='gfield_description_112_123'>Click the \"+\" button until all of your vehicles are added.\n<\/div><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_123_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_123_col_2' class='gfield_list_col_even' \/><col id='gfield_list_123_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_123_col_4' class='gfield_list_col_even' \/><col id='gfield_list_123_col_5' class='gfield_list_col_odd' \/><col id='gfield_list_123_col_6' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">License plate #<\/th><th scope=\"col\">Make<\/th><th scope=\"col\">Year<\/th><th scope=\"col\">VIN<\/th><th scope=\"col\">Body style<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_123_cell1' data-label='License plate #'><input title='License plate #'aria-invalid='false'  aria-describedby=\"gfield_description_112_123\" aria-label='License plate #, Row 1' data-aria-label-template='License plate #, Row {0}' type='text' name='input_123[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_123_cell2' data-label='Make'><input title='Make'aria-invalid='false'  aria-describedby=\"gfield_description_112_123\" aria-label='Make, Row 1' data-aria-label-template='Make, Row {0}' type='text' name='input_123[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_123_cell3' data-label='Year'><input title='Year'aria-invalid='false'  aria-describedby=\"gfield_description_112_123\" aria-label='Year, Row 1' data-aria-label-template='Year, Row {0}' type='text' name='input_123[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_123_cell4' data-label='VIN'><input title='VIN'aria-invalid='false'  aria-describedby=\"gfield_description_112_123\" aria-label='VIN, Row 1' data-aria-label-template='VIN, Row {0}' type='text' name='input_123[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_123_cell5' data-label='Body style'><input title='Body style'aria-invalid='false'  aria-describedby=\"gfield_description_112_123\" aria-label='Body style, Row 1' data-aria-label-template='Body style, Row {0}' type='text' name='input_123[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/cswd.net\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/cswd.net\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/fieldset><\/li><li id=\"field_112_20\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_20\" ><label class='gfield_label gform-field-label' for='input_112_20'>Upload your own form.<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='5242880' \/><input name='input_20' id='input_112_20' type='file' title='Upload your own form.' accept='.xls, .xlsx, .doc, .pdf'class='medium' aria-describedby=\"gfield_upload_rules_112_20\" onchange='javascript:gformValidateFileSize( this, 5242880 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_112_20'>Accepted file types: xls, xlsx, doc, pdf, Max. file size: 5 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_112_20'><\/div><\/div><span id='field_112_20_fmessage' class='sr-only'>Maximum file size - 5 mega bytes. <\/span><\/li><li id=\"field_112_96\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_96\" ><label class='gfield_label gform-field-label' for='input_112_96'>2. Upload proof of insurance<\/label><div class='gfield_description' id='gfield_description_112_96'>If not already on file, have your insurance company submit proof of insurance naming CSWD as an additional policy holder.  Liability insurance must be maintained at or above the following levels: $100K per person and $300K per occurrence for personal injury or death, and $100K per occurrence for property damage.  <\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='5242880' \/><input name='input_96' id='input_112_96' type='file' title='2. Upload proof of insurance' accept='.xls, .xlsx, .doc, .pdf'class='medium' aria-describedby=\"gfield_upload_rules_112_96 gfield_description_112_96\" onchange='javascript:gformValidateFileSize( this, 5242880 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_112_96'>Accepted file types: xls, xlsx, doc, pdf, Max. file size: 5 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_112_96'><\/div><\/div><span id='field_112_96_fmessage' class='sr-only'>Maximum file size - 5 mega bytes. <\/span><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_112_46' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"1\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"1\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_112_46' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"3\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"3\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_112_3' class='gform_page' data-js='page-field-id-46' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_112_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_112_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_58\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Select the waste services you provide<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_58'>Select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_58'><li class='gchoice gchoice_112_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='Landfill-bound Trash'  id='choice_112_58_1'   aria-describedby=\"gfield_description_112_58\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_1' id='label_112_58_1' class='gform-field-label gform-field-label--type-inline'>Landfill-bound Trash<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='Mandatory Recyclables'  id='choice_112_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_2' id='label_112_58_2' class='gform-field-label gform-field-label--type-inline'>Mandatory Recyclables<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.3' type='checkbox'  value='Construction \/ Demolition (C&amp;D) Waste'  id='choice_112_58_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_3' id='label_112_58_3' class='gform-field-label gform-field-label--type-inline'>Construction \/ Demolition (C&D) Waste<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.4' type='checkbox'  value='Yard Trimmings \/ Food Scraps'  id='choice_112_58_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_4' id='label_112_58_4' class='gform-field-label gform-field-label--type-inline'>Yard Trimmings \/ Food Scraps<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.5' type='checkbox'  value='Tires'  id='choice_112_58_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_5' id='label_112_58_5' class='gform-field-label gform-field-label--type-inline'>Tires<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.6' type='checkbox'  value='Scrap Metal'  id='choice_112_58_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_6' id='label_112_58_6' class='gform-field-label gform-field-label--type-inline'>Scrap Metal<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_58_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.7' type='checkbox'  value='Other Special Wastes (banned from landfill)'  id='choice_112_58_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_58_7' id='label_112_58_7' class='gform-field-label gform-field-label--type-inline'>Other Special Wastes (banned from landfill)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_57\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_57\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Select the facility or facilities you use for LANDFILL-BOUND TRASH<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_57'><li class='gchoice gchoice_112_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Casella Transfer Station: Williston, VT'  id='choice_112_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_57_1' id='label_112_57_1' class='gform-field-label gform-field-label--type-inline'>Casella Transfer Station: Williston, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_57_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.2' type='checkbox'  value='Waste USA Landfill: Coventry, VT'  id='choice_112_57_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_57_2' id='label_112_57_2' class='gform-field-label gform-field-label--type-inline'>Waste USA Landfill: Coventry, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_57_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.3' type='checkbox'  value='Other'  id='choice_112_57_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_57_3' id='label_112_57_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_49\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_49\" ><label class='gfield_label gform-field-label' for='input_112_49'>Enter facility name and location<\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_112_49' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_59\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_59\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Select the facility or facilities you use for MANDATORY RECYCLABLES<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_59'><li class='gchoice gchoice_112_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='CSWD Materials Recovery Facility (MRF): Williston, VT'  id='choice_112_59_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_59_1' id='label_112_59_1' class='gform-field-label gform-field-label--type-inline'>CSWD Materials Recovery Facility (MRF): Williston, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_59_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.2' type='checkbox'  value='Other (Private processor)'  id='choice_112_59_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_59_2' id='label_112_59_2' class='gform-field-label gform-field-label--type-inline'>Other (Private processor)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_51\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_51\" ><label class='gfield_label gform-field-label' for='input_112_51'>Enter facility name and location<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_112_51' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_60\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_60\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Select the facility or facilities you use for C&amp;D WASTE<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_60'><li class='gchoice gchoice_112_60_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.1' type='checkbox'  value='All Cycle Transfer Station: Williston, VT'  id='choice_112_60_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_60_1' id='label_112_60_1' class='gform-field-label gform-field-label--type-inline'>All Cycle Transfer Station: Williston, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_60_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.2' type='checkbox'  value='Burlington Area Transfer Station: Williston, VT'  id='choice_112_60_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_60_2' id='label_112_60_2' class='gform-field-label gform-field-label--type-inline'>Burlington Area Transfer Station: Williston, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_60_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.3' type='checkbox'  value='Myers Recycling Facility: Colchester, VT'  id='choice_112_60_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_60_3' id='label_112_60_3' class='gform-field-label gform-field-label--type-inline'>Myers Recycling Facility: Colchester, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_60_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.4' type='checkbox'  value='Other'  id='choice_112_60_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_60_4' id='label_112_60_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_53\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_53\" ><label class='gfield_label gform-field-label' for='input_112_53'>Enter facility name and location<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_112_53' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_61\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_61\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Select the facility or facilities you use for YARD TRIMMINGS \/ FOOD SCRAPS<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_61'><li class='gchoice gchoice_112_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Green Mountain Compost: Williston, VT'  id='choice_112_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_61_1' id='label_112_61_1' class='gform-field-label gform-field-label--type-inline'>Green Mountain Compost: Williston, VT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_61_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.2' type='checkbox'  value='Other'  id='choice_112_61_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_61_2' id='label_112_61_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_62\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_62\" ><label class='gfield_label gform-field-label' for='input_112_62'>Enter facility name and location<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_112_62' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_68\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_68\" ><label class='gfield_label gform-field-label' for='input_112_68'>Enter facility name and location you use for TIRES<\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_112_68' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_69\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_69\" ><label class='gfield_label gform-field-label' for='input_112_69'>Enter the facility name and location you use for SCRAP METAL<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_112_69' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_112_63\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_63\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Other Special Wastes<\/label><div class='gfield_description' id='gfield_description_112_63'>Check all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_63'><li class='gchoice gchoice_112_63_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.1' type='checkbox'  value='Appliances'  id='choice_112_63_1'   aria-describedby=\"gfield_description_112_63\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_1' id='label_112_63_1' class='gform-field-label gform-field-label--type-inline'>Appliances<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_63_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.2' type='checkbox'  value='Electronic waste'  id='choice_112_63_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_2' id='label_112_63_2' class='gform-field-label gform-field-label--type-inline'>Electronic waste<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_63_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.3' type='checkbox'  value='Confidential materials destruction'  id='choice_112_63_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_3' id='label_112_63_3' class='gform-field-label gform-field-label--type-inline'>Confidential materials destruction<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_63_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.4' type='checkbox'  value='Non-regulated hazardous waste'  id='choice_112_63_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_4' id='label_112_63_4' class='gform-field-label gform-field-label--type-inline'>Non-regulated hazardous waste<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_63_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.5' type='checkbox'  value='Clean wood'  id='choice_112_63_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_5' id='label_112_63_5' class='gform-field-label gform-field-label--type-inline'>Clean wood<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_63_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.6' type='checkbox'  value='Other'  id='choice_112_63_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_63_6' id='label_112_63_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_64\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_64\" ><label class='gfield_label gform-field-label' for='input_112_64'>Enter additional materials<\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_112_64' type='text' value='' class='medium'  aria-describedby=\"gfield_description_112_64\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_112_64'>Please separate multiple entries with a comma<\/div><\/li><li id=\"field_112_92\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_92\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Customer education<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_92'>Pursuant to Section 4.8 G of CSWD\u2019s Solid Waste Management Ordinance, commercial haulers are required\nto provide instructions on the proper management of Mandatory Recyclables, Special Wastes, Unregulated Hazardous Waste, and Compostables to new customers when service commences and to all customers on an annual basis at a minimum. Please indicate the method(s) used for delivery of instructions (check all that apply). <\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_92'><li class='gchoice gchoice_112_92_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.1' type='checkbox'  value='Hand delivery'  id='choice_112_92_1'   aria-describedby=\"gfield_description_112_92\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_112_92_1' id='label_112_92_1' class='gform-field-label gform-field-label--type-inline'>Hand delivery<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_92_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.2' type='checkbox'  value='USPS'  id='choice_112_92_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_92_2' id='label_112_92_2' class='gform-field-label gform-field-label--type-inline'>USPS<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_92_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.3' type='checkbox'  value='Email'  id='choice_112_92_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_92_3' id='label_112_92_3' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_112_92_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.4' type='checkbox'  value='Other'  id='choice_112_92_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_92_4' id='label_112_92_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_98\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_98\" ><label class='gfield_label gform-field-label' for='input_112_98'>If other, please specify<\/label><div class='ginput_container ginput_container_text'><input name='input_98' id='input_112_98' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_112_65' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"2\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"2\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_112_65' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"4\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"4\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_112_4' class='gform_page' data-js='page-field-id-65' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_112_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_112_91\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_91\" ><h2>Hauler License Certifications<\/h2>\n<em>Please read all items below and certify your agreement.<\/em>\n<br><\/br>\n<strong>License Applicants: <\/strong><\/li><li id=\"field_112_100\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_100\" >1. Will obtain all other necessary state and local permits and licenses prior to commencing activities under this license. [NOTE: State of Vermont Waste Transportation Permit required for any person that transports solid waste for compensation.]<\/li><li id=\"field_112_101\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_101\" >2. Will comply with all rules, regulations, and ordinances pertaining to the management of solid waste as enacted by CSWD and all applicable federal, state and local laws, rules and regulations. The undersigned understands that failure to comply may result in suspension or revocation of the License and\/or other penalties.<\/li><li id=\"field_112_102\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_102\" >3. Is not delinquent in payments owed to CSWD in excess of 60 days past the billing date, and the required License fee has been paid.<\/li><li id=\"field_112_103\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_103\" >4. Will ensure that employees and personnel have received the education and training necessary to safely and properly conduct the undersigned\u2019s activities under the License.<\/li><li id=\"field_112_104\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_104\" >5. Will ensure financial resources are adequate to allow the undersigned to safely and properly conduct the undersigned\u2019s activities under the License.<\/li><li id=\"field_112_105\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_105\" >6. Will not unduly pollute any element of the environment nor impose any undue burden upon any element of the community.<\/li><li id=\"field_112_106\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_106\" >7. Will maintain liability insurance coverage at or above the following levels for the term of the License: $100,000 per person and $300,000 per occurrence for personal injury or death, and $100,000 per occurrence for property damage.<\/li><li id=\"field_112_107\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_107\" >8. Indemnifies and holds harmless CSWD from any and all claims, damages, losses and expenses (including attorneys\u2019 fees) to the extent caused by the undersigned\u2019s performance under the License or the performance by any agents, officers, subcontractors, employees, or personnel of the undersigned at facilities owned, leased, or operated by CSWD.<\/li><li id=\"field_112_108\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_108\" >9. Will ensure that every vehicle used by the undersigned or on the undersigned\u2019s behalf in the collection, transfer, transport, or disposal of solid waste will be prominently labeled with an identification number provided by the District. [NOTE: Decals must be visible on the right and left sides of the vehicle.]<\/li><li id=\"field_112_109\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_109\" >10. Will not deliver nor dispose of any solid waste generated within CSWD at any facility not designated in his or her Hauler\u2019s License. [NOTE: Hauler must notify CSWD of any changes in destination of waste generated in the District.]<\/li><li id=\"field_112_110\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_110\" >11. Will not place or cause to be placed any solid waste on private property unless lawfully authorized by the owner of the property and such placement is lawfully permitted.<\/li><li id=\"field_112_111\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_111\" >12. Will not transport solid waste unless such vehicle securely contains the solid waste in a manner that, while in transit, will prevent any of the solid waste and related liquids from escaping or leaking from the vehicle.<\/li><li id=\"field_112_112\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_112\" >13. Will ensure that any solid waste destined for disposal be delivered to and deposited at a transfer or disposal facility within forty-eight (48) hours of collection.<\/li><li id=\"field_112_113\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_113\" >14. Will provide (independently or through duly licensed subcontractors) collection of mandatory recyclables at least once monthly to all customers for whom such Hauler provides collection of solid waste destined for disposal. The undersigned will not offer and his customers will not subscribe to trash only collection service unless recycling collection service is provided or subcontracted by CSWD or a member municipality or unless they obtain an exemption from CSWD.<\/li><li id=\"field_112_114\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_114\" >15. Will provide instructions on proper management of mandatory recyclables, special waste, unregulated hazardous waste, and compostables to new customers when service commences and to all customers on an annual basis at a minimum.<\/li><li id=\"field_112_115\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_115\" >16. Will not dispose of mandatory recyclables that are properly prepared and set out for collection.<\/li><li id=\"field_112_116\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_116\" >17. Will not knowingly accept landfill-bound waste set out for collection that contains mandatory recyclables, hazardous waste, special wastes, or yard trimmings. The Hauler will alert CSWD of customers not source-separating banned landfill materials from trash destined for disposal.<\/li><li id=\"field_112_117\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_117\" >18. Will comply with the container labeling requirements in CSWD's Solid Waste Management Ordinance.<\/li><li id=\"field_112_118\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_118\" >19. Will weigh solid waste hauled that is destined for disposal that was generated in CSWD on a District-licensed scale.<\/li><li id=\"field_112_120\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_120\" >20. Will submit to CSWD on a quarterly basis the quantity of scrap tires hauled from Chittenden County by weight, volume or count on a form provided by the District, if not weighed on a District-licensed scale. <\/li><li id=\"field_112_89\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_89\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >I have read and agree to all of the terms listed above.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_112_89'><li class='gchoice gchoice_112_89_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.1' type='checkbox'  value='I agree'  id='choice_112_89_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_112_89_1' id='label_112_89_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_67\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_67\" ><label class='gfield_label gform-field-label' for='input_112_67'>By initialing below I attest, as a representative of the above Hauling company, the information provided on this application and all accompanying documents is true, accurate, and complete.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_67'>Please enter your initials in the box below.<\/div><div class='ginput_container ginput_container_text'><input name='input_67' id='input_112_67' type='text' value='' class='medium'  aria-describedby=\"gfield_description_112_67\"   aria-required=\"true\" required aria-invalid=\"false\"   \/> <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_112_47' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"3\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"3\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_112_47' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_112\").val(\"5\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_112\").val(\"5\");  jQuery(\"#gform_112\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_112_5' class='gform_page' data-js='page-field-id-47' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_112_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_112_41\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gf_left_third gfield_price gfield_price_112_41 gfield_product_112_41 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_41\" ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_112_41_1'><span class=\"gform-field-label gfield_label_product\">Truck license fee<\/span> <span class=\"screen-reader-text\">Quantity<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_112_41'>Enter the number of trucks you are licensing (should match the total number of trucks entered under \"Vehicle Information\"). <\/div><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_41.1' value='Truck license fee' class='gform_hidden' \/>\n\t\t\t\t\t\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/span>\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price' id='input_112_41'>$15.00<\/span>\n\t\t\t\t\t\n\t\t\t\t\t<input type='hidden' name='input_41.2' id='ginput_base_price_112_41' class='gform_hidden' value='$15.00'\/>\n\t\t\t\t\t <span class='ginput_quantity_label gform-field-label' aria-hidden='true'>Quantity<\/span> <input type='number' name='input_41.3' value='' id='input_112_41_1' class='ginput_quantity' size='10' min='0'   aria-label=\"Quantity Truck license fee\" aria-describedby=\"gfield_description_112_41\" \/>\n\t\t\t\t<\/div><\/li><li id=\"field_112_42\" class=\"gfield gfield--type-total gfield_price gfield_price_112_ gfield_total gfield_total_112_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" data-js-reload=\"field_112_42\" ><label class='gfield_label gform-field-label' for='input_112_42'>Total due<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<span class='ginput_total ginput_total_112'>$0.00<\/span>\n\t\t\t\t\t\t\t<input type='hidden' name='input_42' id='input_112_42' class='gform_hidden'\/>\n\t\t\t\t\t\t<\/div><\/li><li id=\"field_112_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_44\" ><label class='gfield_label gform-field-label' >How would you like to pay?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_112_44'>\n\t\t\t<li class='gchoice gchoice_112_44_0'>\n\t\t\t\t<input name='input_44' type='radio' value='Check\/Money Order (made payable to CSWD)'  id='choice_112_44_0'    \/>\n\t\t\t\t<label for='choice_112_44_0' id='label_112_44_0' class='gform-field-label gform-field-label--type-inline'>Check\/Money Order (made payable to CSWD)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_112_44_1'>\n\t\t\t\t<input name='input_44' type='radio' value='Cash'  id='choice_112_44_1'    \/>\n\t\t\t\t<label for='choice_112_44_1' id='label_112_44_1' class='gform-field-label gform-field-label--type-inline'>Cash<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_112_45\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_112_45\" >Please send a check for full payment to:\n\nChittenden Solid Waste District\nATTN: Hauler's License\n19 Gregory Dr., Suite 204\nSouth Burlington, VT 05403<\/li><\/ul><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_112' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='if(window[\"gf_submitting_112\"]){return false;}  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site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hauler License Application (Online) - CSWD<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cswd.net\/forms-publications\/hauler-license-application\/\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cswd.net\/forms-publications\/hauler-license-application\/\",\"url\":\"https:\/\/cswd.net\/forms-publications\/hauler-license-application\/\",\"name\":\"Hauler License Application (Online) - 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