HomeMy WebLinkAbout2850 INDEPENDENCE AVEExemption year: 20�C�
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Applicant's Name:
Billing Address:
Address of Exemption:
Water Works Account No.:
Date �-8'�
Telephone No 31q Z90 l01�7
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.
Applicant's Signature
TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER:
(We)
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
a�s�c prope�tz��s
Address Location of
Garbage/Trash Pick -Up
a8� � � , ,�nC.�
Beginning
Date of
Contract
,.�
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.
�:,•
Date
Signature of Authorized Company Representative
April 9, 2020
To whom it may concern at the City of Waterloo Sanitation Department,
I have attached an exemption form for my trash service at 2850 Independence ave. 1 had
previously requested the yard waste and recycling totes at 2850 Independence ave. be picked
up in November of 2019, as they have not been used.
I wanted to ensure that they are still on the list for removal, and that we will not be billed for
them, as we are not and have no intention of utilizing them.
With the current covid situation, we are not rushing removal of these containers. I'd like only to
confirm that they are set for removal and we would not be charged for them being stored at my
location until you've had someone pick them up,
do not require a response as long as we are not being billed for them. If you need further
information or assistance, please contact me.
Thank you,
Heather Seemann
Basic Properties LLC.
2301 Idaho St
Waterloo, IA 50707
319-290-6672