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Livestock Waste Hauling Permit Application Form

Owner/Company Name
Owner/Company Address
Owner/Company Mailing Address
Phone Number
Cell Phone Number
Email Address:
Business is a
1. Corporation
2. Sole Proprietor
1. Joint Venture
2. Self Hauler
1. Partnership
2. Professional Association
Corporate Parent Name (if any)
Trade Name (if any) e.g. d/b/a
Address
Telephone
Company Representative (Name & Title)
Cell Phone Number
Email Address
Individual Supervising Activities in Wellington (Name & Title)
Cell Phone Number
Email Address
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Livestock Waste Hauling Stickers

Livestock waste hauling stickers will be distributed upon the approval of your livestock waste hauling permit. These permit stickers will be required to be placed on the window of all trucks that are certified to haul throughout Wellington. There is no charge for the first two permit stickers issued. An additional charge of $5.00 per sticker will be applied for all stickers thereafter. Please list truck information below, making sure to complete all fields:
Truck 1
Year
Make/Model
Color
License Plate Number
US DOT Number
Truck 2
Year
Make/Model
Color
License Plate Number
US DOT Number
Additional Stickers at $5.00 per truck
Truck 1
Year
Make/Model
Color
License Plate Number
US DOT Number
Truck 2
Year
Make/Model
Color
License Plate Number
US DOT Number
Truck 3
Year
Make/Model
Color
License Plate Number
US DOT Number
Truck 4
Year
Make/Model
Color
License Plate Number
US DOT Number
Truck 5
Year
Make/Model
Color
License Plate Number
US DOT Number
Additional Stickers at $5.00 each equals
Additional Stickers + $500.00 Annual Permit Fee = Total Due
Please submit payment for additional stickers along with payment for the annual permit fee.
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Disposal Sites

Permittee shall identify all livestock waste disposal site (s) to which the Permittee proposes to deliver livestock waste under this hauling permit. All disposal locations shall meet the definition of approved disposal site (s) as provided in the Village's BMP Ordinance 2012-12, where livestock waste will be hauled, for processing, land application or disposal. The Permittee shall provide a letter from each property owner authorizing disposal of Livestock Waste.
Site 1
Company Name
Address
Contact Name
Phone Number
Delivered location of waste and method of disposal
Site 2
Company Name
Address
Contact Name
Phone Number
Delivered location of waste and method of disposal
Site 3
Company Name
Address
Contact Name
Phone Number
Delivered location of waste and method of disposal
Site 4
Company Name
Address
Contact Name
Phone Number
Delivered location of waste and method of disposal
Site 5
Company Name
Address
Contact Name
Phone Number
Delivered location of waste and method of disposal
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General Permit Conditions

1. All hauling activities on or within the Village of Wellington/Acme Improvement District roads, easements or rights-of-ways is permitted hereunder and shall be performed in strict compliance with this permit. Permittee shall comply with the Village of Wellington's BMP Ordinance 2012-12 and all applicable laws and standards of the State of Florida regulating hauling and disposal of livestock waste, including but not limited to, proper hauling procedures, disposal methods and documentation of the amount of livestock waste being transported monthly and reported quarterly to the Village of Wellington.
2. The granting of this permit does not give the Permittee a right, but only grants the Permittee a privilege subject to the strict control of the Village/District. This permit shall not relieve the Permittee from complying with any law, regulation or requirement affecting the rights of other bodies or agencies.
3. All livestock waste containerized or transported by the Permittee hereunder shall remain the property of the Permittee until proper disposal occurs with supporting documentation or as otherwise provided immediately below.
4. The Permittee will be responsible for any damages to drainage structures, utilities, canals or roadways. Additionally, the Permittee agrees to reimburse the Village of Wellington for expenses incurred for damages caused to Village property and/or maintenance of shell rock roads caused by the Permittee in carrying out activities under this permit.
5. The Permittee shall comply with the rules, regulations and standards of respective homeowners association guidelines (if applicable) for the uniform protection of the landowners throughout the Village/District.
6. This permit expires each year on September 30th at midnight and must be renewed annually.
7. This permit may be revoked by the Village/District at any time without cause, with thirty (30) days written notice to Permittee.
8. This permit may be immediately revoked by the Village/District, without notice to the Permittee, for failure of the Permittee to comply with the conditions of this permit.
9. The Village/District reserves the right to periodically audit the hauling records of the Permittee to ensure compliance with the conditions of this permit.
10. This permit must be available at all times during the permitted activity.
11. Permittee agrees to restrict hauling to Monday thru Saturday 7:00 am to 6:00 p.m. and Sunday 9:00 am to 6:00 pm and shall be subject to all laws, Village ordinances and codes, rules and regulations.
12. This Permit is a limited use permit for livestock waste hauling only; all other hauling of materials must be permitted separately.
Under penalty of perjury, I declare that I have read the foregoing document and the facts stated herein are true. Additionally, I have read, understand and will comply with the terms and conditions of the Livestock Waste Hauling Permit Agreement, the Village of Wellington Best Management Practices (BMP's) Ordinance 2012-12, and all other applicable laws and regulations.
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature*
Date*
Date

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Livestock Waste Hauling Permit Application Form

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Livestock Waste Hauling Permit Application Form

Livestock Waste Hauling Stickers

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Truck 1

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Truck 3

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Truck 5

Disposal Sites

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General Permit Conditions

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