HomeMy WebLinkAboutEExemption year: ..;:41
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
. CITY OF WATERLOO, IOWA
�rnicY Q,1/4 INcl-(4,39
Date
Applicant's Name:
Billing Address:
hwapie ,le_rs
Telephone
fiO Aox se `,1A-1--e_�l
Address of Exemption:
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No. 7.3 -C/O/
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Water Works Account No.:
og s-” - sva a(53
I request an exemption from Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the,
trash hauler picks up garbage and trash will qualify for the exemption.
Applicans Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We) ! ) j J�� !t e L_))
Company Name
a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up
garbage and refuse at the following location:
hereby declare that we are
Address Location of
Customer's Name Garbage/Trash Pick -Up
Beginning Ending
Date of Date of
Contract Contract
c90/z/ sa/4ck/ ,& l l /%' /2 r%
CONTRACT PERIOD MUST COVER T LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements and above schedule, and to the best of my
knowledge and -belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission,
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
Date
PLEASE RETURN TO:
Signature( f Authorized Company Representative
33--4/ c /40
Company's Addr
Garbage & Trash Hauler's Permit License
(issued by Black Hawk County)
CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white Customer's Copy - yellow
PRIVATE
Exemption year: �' % /12
HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Date
Applicant's Name: bw)111.k- ri�er:1 Telephone No. j/q7 9'�3®%/
ntl, e S-0? /it 3-0/70 Ai
Billing Address:
Address of Exemption: l Fg FTgJ/ s /lye I q e, der,
Water Works Account No.: /71, //d2 - S"/aZd2 j
S4
I request an exemption from Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the..
trash hauler picks up garbage and trash will qualify for the exemption.
•
1, J Y \ CX'f�1
Applican4 s Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
.1)1Lttie R le r -s
Company Name
a licensed trash hauler in the City of Waterloo, Iowa, and that we
garbage and refuse at the following location:
(We)
hereby declare that we are
Customer's Name
�Lo a yn e f ),` /e vJ
Address Location of
Garbage/Trash Pick -Up
Beginning
Date of
Contract
/602,0 FFl/s /9ve g— /7
pick up
Ending
Date of
Contract
CONTRACT PERIOD MUST COVER AI LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements and above schedule, and to the best of my
knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission.
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
--A9 - / 1 I. -,r te e
Date Signaturof Authorized Company Representative
,;60 / le a tk.ei )1e4, 1 JthJrt
Company's Address
/1"/
Garbage & Trash Hauler's Permit License
(issued by Black Hawk County)
PLEASE RETURN TO: CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white Customer's Copy - yellow
Exemption year: 0,1
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Date
Applicant's Name: DLUCO, 1e ( `.
C)-0 x �3 YJc 'l(D) 7 7Y51 0 -1-"i
Address of Exemption: t153 '12 \--„hip WC Diff -1
Water Works Account No.: - `J " 1 - 02(1 1oZ S
Billing Address:
Telephone No.--1j161-c."S51C)i
I request an exemption from Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the,
trash hauler picks up garbage and trash will qualify for the exemption.
App ica
iRk)
Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We) NJ c'U—A ce k91 N i C (.%
._, Company Name
a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up
garbage and refuse at the following location:
hereby declare that we are
Beginning Ending
Address Location of Date of Date of
Customer's Name Garbage/Trash Pick -Up Contract Contract
oww6o2 A \e‘c-
CONTRACT PERIOD MUST COVER AT LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements .and above schedule, and to the best of my
knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission.
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
3-"3-I�l
Date
PLEASE RETURN TO:
PR
Signature
Company's
f Authorized Company Representative
Address
Garbage & Trash'Hauler's Permit License
(issued by Black Hawk County)
CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white
Customer's Copy - yellow
Exemption year: 0?0/(5'.
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
. CITY OF WATERLOO, IOWA
Date / 0A1 rs)
Applicant's Name: R0.6 4``1 GL/►1 re Telephone No. ,i7,3-8...„)/3
Billing Address: 1 %�) ,11.s Trn 4/t/� , lAiQ4-er100,,LA 5-D`70Q-
Address of Exemption: "SCAM .e
Water Works Account No.:
tLr6rH-C3sioy
I request an exemption from. Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the;
trash hauler picks up garbage and trash will qualify for the exemption.
pp li ant' nature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We) 23\cL Yvey10,2(r
Company dame
a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up
garbage and refuse at the following location:
hereby declare that we are
Beginning Ending
Address Location of Date of Date of
Customer's Name Garbage/Trash Pick -Up Contract Contract
CONTRACT PERIOD MUST COVER AI LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements and above schedule, and to the best of my
knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission.
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
--ki‘e`—‘gr\
Date Signature of Autize• Company Representative
11 liealcn'h
Company's Address
Garbage & Trash Hauler's Permit License
(issued by Black Hawk County)
PLEASE RETURN TO: CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white Customer's Copy - yellow
Exemption year: 2 01'_)
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Date
Ir_ lc/ i
r
Applicant's Name:
Billing Address:
lac � d- j a yi DV
Telephone No.y(F -S'
Address of Exemption:
'SCA e
Water Works Account No.: 1 J 8 X 7 -j - S.3 S10 `1
I request an exemption from Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the.
trash hauler picks up garbage and trash will qualify for the exemption.
f
lhpplicant's Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We) I�\a c \C-
Company ame
a licensed trash hauler in the City of Waterloo, Iowa,
garbage and refuse at the following location:
hereby declare that we are
Customer's Name
and that we pick up
Beginning
Address Location of Date of
Garbage/Trash Pick -Up Contract
\1LE in WI Ii ► Shy / \H -!
Ending
Date of
Contract
CONTRACT PERIOD MUST COVER AT LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements and above schedule, and to the best of my
knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission.
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
\D--00—)
Date
PLEASE RETURN TO:
Signature of Authorized pay Representative
S\ NRS(
Company's Address
Garbage & Trash1l'duler's Permit License
(issued by Black Hawk County)
CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white Customer's Copy - yellow
40?
Exemption year: .epi /
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Date
Applicant's Name:
Billing Address:
gss`r c`d,
t ei/e 5 47-74-e-- %, r
Address of Exemption: s$ Ani.
Telephone No .a% 32 V
Water Works Account No.: /5 _ 70 ^6,6 1/1- J
I request an exemption from Garbage Fees during the current Calendar Year. I
employ the services of a licensed trash hauler. Only the location where the,
trash hauler picks up garbage and trash will qualify for the exemption.
App -1417 's Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We) 6142c-- GJ��7 PrS
Company Name
a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up
garbage and refuse at the following location:
hereby declare that we are
Customer's Name
Tett" 6SS -12/7
CONTRACT
Beginning Ending
Address Location of Date of Date of
Garbage/Trash Pick -Up Contract Contract
33k&s,� e —i—V 1 13-31-x-7
PERIOD MUST COVER AT LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for
exemption from garbage fees for the current calendar year. I, the
undersigned, declare under penalty of perjury that I have examined this
claim, including all statements and above schedule, and to the best of my
knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I
agree to comply with all ordinances and policies of the City of Waterloo and
the Black Hawk County Solid Waste Commission.
In the event that the above person discontinues service with said company
during the current calendar year, we hereby agree to notify the Clerk's
Office of this event by calling 291-4323.
\ C r Il
Date
PLEASE RETURN TO:
k-A-ofahf:10ompany Representative
.AAA
s�� 9ea�,rnm hve
Company's Address
Garbage & Tra Hauler's Permit License
(issued by Black Hawk County)
CITY CLERK & FINANCE OFFICE
715 MULBERRY STREET
WATERLOO, IOWA 50703
City Clerk's Copy - white Customer's Copy - yellow