City of Minneapolis Adopt-a-Block application form

City of Minneapolis

Adopt-a-Block application form

Thank you for your interest in the Adopt-a-Block Program, sponsored by the City of Minneapolis, Division of Solid Waste and Recycling. This program was introduced in the Spring of 1997, and has been incorporated into the Clean City Minneapolis initiative. The Adopt-a-Block program is a way for local groups, organizations or individuals to adopt one or more city blocks within Minneapolis. Your application to this Program pledges that you will clean up the adopted block, and maintain it for a minimum of two (2) years. By participating in this program, you agree to: 1. Adopt the entire block. All four (4) sides including the alley, if there is one. 2. Clean the public sidewalks, curbs, and boulevard greenbelts of the block, corner to corner, and through the alley. 3. Adopt the block for a minimum of two years. 4. Clean the block at least four times per year, including litter cleanup, weed removal and storm grate cleaning. 5. Place bagged litter at your collection point for disposal by Solid Waste & Recycling staff or your private garbage hauler. 6. Hold the City of Minneapolis, Division of Solid Waste and Recycling free and harmless of all liability in connection with this program. The adopter assumes all liability and responsibility for all volunteers participating in scheduled cleanup events. When the application is approved, Solid Waste staff will send a confirmation authorizing the adopter to conduct scheduled cleanups. Questions about this program should be directed to the Clean City Coordinator, City of Minneapolis at 612-673-2789.

Please provide your contact information

Group / Organization name

Contact Name*

Applicant name

Contact address*

Contact phone*

Contact email

What City blocks do you wish to adopt?

Please complete the following information to identify the City blocks you would like to adopt:

North boundary street name

Select or enter value

South boundary street name

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East boundary street name

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West boundary street name

Select or enter value

Total number of blocks

What are the approximate dates you plan to hold your clean up events?

The Adopt-A-Block Program requires cleanup at least four (4) times during the year (running 12-month period).

Year one - first clean up date

Year one - second clean up date

Year one - third clean up date

Year one - fourth clean up date

Year two - first clean up date

Year two - second clean up date

Year two - third clean up date

Year two - fourth clean up date

Would you like a "Do Not Litter" sign for your yard?

Select or enter value

Do you agree to hold the City of Minneapolis, Division of Solid Waste and Recycling free and harmless of all liability in connection with this program? The adopter assumes all liability and responsibility for all volunteers participating in scheduled cleanup events.*

Select

Signature*

Date*

Send me a copy of my responses

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