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HomeMy WebLinkAboutRExemption year: O1 / PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date Applicant's Name: ( V�rS Ed9.C, ()»-73'1 jacil Telephone No. oi33-00S5' Billing Address: /.2 C/7 &chr &,1d SA Address of Exemption: Same_ as 6,66.`2_ Water Works Account No.: /2 `/D (2 - 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. 1246), eeec 2taud. Applicant's Signature TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) Vil&X)0144-1He Company lame hereby declare that we are a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: • Beginning Ending Address Location of Date of Date of Customer's Name Garbage/Trash Pick -Up Contract Contract 1riS&L() (1 2616 ix) Odor 6 JO '3.N CONTRACT PERIOD MUST COVER AlLEAST 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. Datef 723 ( Signature of Authorized ompany Representative ompany's Address ()0 � 0 e Mi« )J fir. Garbage & Tra h Hauler's Permit Li ense (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: PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL, CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date .%5(14 1/c -7 , Applicant's Name: F�tpp, Ve4/S ( Telephone No. Billing Address: Address of Exemption: isq. C,�f�v ivt pn1/- -Ttvv SC -103 R(f7 UPI aei C4-( 0440 7703 Water Works Account No.: 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. g AL Applicant's Signet TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) Company Name LLQ hereby declare that we are a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: Beginning Ending Address Location of Date of Date of Customer's Name Garbage/Trash Pick -Up Contract Contract —(A)S C d rig( C d m -v d ra(77 1/— n 6 itisrPE Nv CONTRACT PERIOD MUS COVER AT LEASTSST CURRENT RENT 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. 5 i X 4-1)T1 � J�4C' ,�Q1 /4/71'69( //1/44,t121/ Date Signature of Autho zed Comp ny Representative 04,t414 4167-1,1 L -LL ;10 0)0 (96041 finifj1.1 (014(4 -7-74-1143g k- 0 25 o 4 (9xrh4&u{cs ) Garbage & Trash Hauler's Fermi License (issued by Black Hawk County) Company's Address PLEASE RETURN TO: CITY CLERK & FINANCE OFFICE 715 MULBERRY STREET WATERLOO, IOWA 50703 City Clerk's Copy - white Customer's Copy - yellow Exemption year: 2-11117- PRIVATE 0PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date Applicant's Name: Rj �% C(O��e CV7,13¢j601 CARLA Telephone No.03/ %) "?33-0055' Billing Address: 7 Cedarc6p4nd <6 -.cd - Address of Exemption: /24/7 &day' Ap,aI S**.e Water Works Account No.: * 12,", 66V— '5-l62 im 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. J144,, 9x7.14 . Applicant's Signature / TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) RC : E.- 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 12.`"r2 vp E (1 f C) 17[3[ l(? 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(°3c3(c� Date Signe ure of Authorized Company Representative Z(QcZ —C s Company's Address age & Tras 'au-=r's =rmit 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: : Li'f 7 PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date ,:-dam., -/ Applicant's Name: X cl s'F .L c' -h e r 7s Telephone No f f 9e, Y 7C«S Billing Address: 9/S S�rdvr.1.:;z l J.!) Address of Exemption: 0S Su. ,..� . j- iQ S LS 0701 Water Works Account No.: Sd 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. Ce -icant u. C . --> 1,4 -�`�'� App141=s SicjY}ature TO BE COMPLETED BY LICENSED GARBAG AND TRASH HAULER: (We) Company Name hereby declare that we are a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: Beginning Ending Address Location of Date of Date of Customer's Name Garbage/Trash Pick -Up Contract Contract I SSO,,\\b_ickos-4-s ( SunryA. I-1-1' - IZ3 t-1 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 229 4323. -40,50„// 23 -1 Date w ure of Author -d Company Representative it 1Cs IJ icy`) (5"a l0- "om s �dcTress (1W 11 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: 67/ PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date Applicant's Name: (\ uss;f ?_ Billing Address: Telephone No3/75"M" VNi Address of Exemption: 62s-6, Water Works Account No.: 77r'`2a' ✓ 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 l .e` t -44d, } a Applicant's Signature TO BE COMPLETED BY LICENSED GARBAGE,AND TRASH HAULER: (We) g(;{ ^.� �� » L {kl a S -4i ;', q '6(1561/ hereby declare that we are Company Name a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: Beginning Ending Address Location of Date of Date of Customer's Name Garbage/Trash Pick -Up Contract Contract 1 1 Lel -% IFa � 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. s �In�(/✓� / /i /// m, Skgna-ture/of Author --d Company Representative Date Cbmpany"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: ;;,70/7 PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date lz--3 4‘• Applicant's Name: Jfri/ cH,/\ Telephone N0.1, . hzAi Billing Address: / wip- OWL/ ' iizkl-vides ap.- Address of Exemption: ' '13‘7-7 ALJ rl /3"4-(1 t' 4/P.iciri20 ei IL - Water Works Account No.: lb /307 — 5-00 3f 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. TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) /7EW.ei k.21-121) f ray 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 27 dy1F•l/51.r�cr- 1-1-17 11-31—/7 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. Date ature o Authorized Company Representative -e t4 /' ✓i i {K/C/i 6, Company's Address L Garbage &J Trash rash 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 PRIVATE Exemption year: 20/7 HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA t Date (Z'S/ Applicant's Name: Billing Address: Address of Exemption: Water Works Account No.: Telephone No. / 7c/ 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. D /7 Applicant's Signature TO BE COMPLETED BY LIC fY � (We) /7 -Ey NSED GARBAGE AND TRASH HAULER: .rI iy c Company Name a licensed trash hauler in the City of Waterloo, garbage and refuse at the following location: Customer's Name CONTRACT hereby Iowa, declare that we are and that we pick up Beginning Address Location of Date of Garbage/Trash Pick -Up Contract 7 YY^ r Ending Date of Contract f2 _ Z i—/ 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. / t Date tic S_I-g ature of Authorized Company Representative ',h / hl/ik- / %c Company's` Address Cy ( 7 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: 02a -0701 PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date \V/0 Applicant's Name: Billing Address: kil/n/Le Telephone No0q�4/0- 084 1 nit r d /dc i/ , /Qq, 71/4trinvTett 1/(e " 6: / loetacs&rim/Rozpi416--go)/44\(,-s-5zfon, /666-6--540746, /o$)-1 Address of Exemption: Water Works Account No I request an exemption from Garbage Fees during the curren Cale dar Year. I employ the services of a licensed trash hauler. ray t - oca n where the: trash hauler picks up garbage and trash will lify f•. �-- ption. Applicant's Signature TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) I3bci'-[Jai'K ompany Name hereby declare that we are a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: Customer's Name LLQ. Beginning Ending Address Location of Date of Date of Garbage/Trash Pic -Up Contract Co tract z1�/101 Cfli:115 n --)-l/- 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 -ar, we hereby agree to notify the Clerk's Office of this event by calli.• 291-4323. ;BM C gn - Date ure o orized Company Representative gj/ �c in 0/1-/-lc�� Compa i' 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: PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date ioa:(1 Applicant's Name: can'Rogers JTelephonne Noo..i�-7 Billing Address: I I I Rebecm LN LUQ� rloo 2fl ✓0 Q 7 Address of Exemption: 111 �beoca LN w rico sola 7 Water Works Account No.: f0t3i4-15300Xp 1 request an exemption from Garbage Fees durin employ the services of a licensed trash trash hauler picks up garbage and tY s.cant's S natur TO BE COMPLETED BYL CENSED GARBAGE AND TRASH HAULER: (We) //OKl ct.> 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 Dn Beginning Ending Address Location of Date of Date of Garba e Trash Pick -Up Contract Contract ►� ill ,� afa LN u,* g -I-/7 iz- 31- 7 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 ?91-43.23. Date10 p2'1l a ur JeeMIM Signature of Authorized Company Representative 81( Deorbrirn obti L4A11 ) 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: Vt./7 PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date 9.'31- eD// Cr Applicant's Name: V I hey- A5s Billing Address: / 0 4 6 4 S Telephone No.GIG/- /7 cL/O Address of Exemption: L /1/ Water Works Account No.: Q �� - d DS 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. 4Applicant s Signature TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (We) J,4 L % ' J/,AlUL•,t13 SckALA ..hereby declare that we are Company Name a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: Customer's Name LUTh, Ra55 Address Location of Garbage/Trash Pick -Up Beginning Ending Date of Date of Contract Contract iPi/ /3111:-.5 ';� /-D f01 -3J- )c/7 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/ - Date Signature of Au£h• zed Company Representative Company's/ o� © Address 5-7 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