HomeMy WebLinkAbout3833-3865 TRENT LANEExemption year: ULC) d®i
PRIVATE HAULER GARBAGE EXEMPTION APPLICATION
RESIDENTIAL CUSTOMERS ONLY
CITY OF WATERLOO, IOWA
Date I -
Applicant's Name: Tt�a� �y ����rido � Q5s•�Telephone No.3►`r Zyc'`3i
Billing Address: �� G j' ^%iL . ;� /N))�Vo
Address of Exemption: ✓ t �cJi0cle 'ti 1� c^//��I
Water Works Account No.: 5c = d 4 � L
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.
icant's Signature
TO BE COMPLETED BY LICENSED GARBAGE 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
� .. l1/ � ..� s. 3 _s 'Ttic a IT
7r
CONTRACT PERIOD MUST COVER AT LEAST CURRENT CALENDAR YEAR
We understand that the above information is used by the Clerk's Office in
ibility
Waterloo, City Hall, 715 Mulberry Street, to determine eligfor
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.
ICI � I) t/I/..�LLX04
Date Signature of Authorized Company Representative
0
�e & 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
Trent Hill Condominium Homeowners Association
3865 Trent Lane
Waterloo, IA 50701
Private Hauler Garbage Exemption Application
Address of Exemption
3833 Trent Lane
3835 Trent Lane
3847 Trent Lane
3849 Trent Lane
3855 Trent Lane
3857 Trent Lane
3863 Trent Lane
3865 Trent Lane
3844 Trent Lane
3846 Trent Lane
3834Trent Lane
3836 Trent Lane
Water Works Account Number
112273-518030
112275-518030
112276-518030
112277-504520
112278-504520
112279-518030
112274-510647
112280-518030