Collection of Information Colac Otway Shire is committed to protecting your privacy. The personal information requested on this form is being collected by Colac Otway Shire for the purpose of issuing a permit or any other related purpose. The personal information will also be disclosed to the Information Management and Customer Service departments for the purpose of record management, taking payment, and issuing a permit. It will not be disclosed to any other external party without your consent, unless required or authorised by law. If the personal information is not collected, a permit will not be issued. If you wish to alter any of the personal information you have supplied to Colac Otway Shire, please contact Council via telephone on 5232 9400 or email inq@colacotway.vic.gov.au. Council’s Privacy Policy is available from our website: colacotway.vic.gov.au/Council-the-shire/Council-policies and all Council Customer Service Centres.Not valid until permit is issued Fees Apply Bulk Rubbish $46 per week (33mtr skip) ANY other item $78 plus $46 per week Your Details First name Last name Company Best phone number to contact you on Email Residential or postal address Residential or postal address Location and Container Details Location where item is to be placed Location where item is to be placed Start date End date Describe article or item to be placed on Council Land/Road Attach a sketched plan of preferred location of bulk bin or other item Upload Upload requirementsOne file only.20 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Bulk Rubbish (3³ mtr skip) How many bulk rubbish skips are required? Qty Other Item How many other items are required? QTY Insurance Policy - Certificate of Currency Applicant’s Public Liability Insurance Policy Certificate of Currency noting Colac Otway Shire as an interested party (with proof of a minimum $20 million Public Liability Insurance coverage attached. Upload Upload requirementsOne file only.20 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Proceed to Payment Leave this field blank