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HomeMy WebLinkAboutTRENT HILL CONDOSExemption year: ZD Y PRIVATE HAULER URESIDENTIAL GARBAGE US EMPTIONNAPPLICATION CITY OF WATERLOO, IOWA Date gal —7^ ,� I Co �i M O. ASS°"Telhone No.3 i �1 °LU"319 Applicant's Name: /fie � � `' epy.,� _co v'v 3�3G %�.of Lati � in : Billing Address: Address of Exemption: � � It Water Works Account No.: r I plby theaserviceslof afrom licensedGarbage trashFees hauler. the Onlycurrent locationawhereYear. the trash garbage and trash w ll qualify for the exemption. trash hauler picks up Applicant's Signature (�CCul��vry TO BE COMPLETED BY LICENSED GARBAGE�AND TRASH HAULER: (We) Oath A'4alc �`.'/ t ,)� h 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 Garbage/Trash Pick -Up Contract Contract Customer's Name � � �^ 1 -u / Z � .� � �� -Txe Ot All o.�JcicS 343s� A.iti �vt CONTRACT PERIOD MUST COVER AT LEAST CURRENT CALENDAR YEAR Wein a understand thatHthe 715° Mulberry Street, to n is used determine Clerk's eligibl eligibility Office for Waterloo, City Hall,y exemption from garbage fees for the current that eId haute examined this undersigned, declare under penalty of perjury claim, including all statements and above schedule, and to the best of my knowledge andbewith git is a TRUEall ordinances, andCORRECT Npolicies of COMPLETEthe that I of Waterloo and agree to comply the Black Hawk County Solid Waste Commission. In the event that the above person discontinues hereby agree service notih said co panY during the current calendar year, we Office of this event by calling 291-4323. Date cj1 S C SitlV'fe of Authorized Company Representative I /tit,cfi-1,116U-t•LA-N."-g)6(er Company's Address cLip Garbage & Trash Hauler's Permit License (issued by Black Hawk County) PLEASE RETURN TO: CITY MCLERK &Y FINANCE OFFICE 7WATERLOO, 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 3834 Trent Lane 3836 Trent Lane Water Works Account Number 112273-518030 112275-518030 112276-518030 112277-504520 112278-504520 112279-518030 112274-510647 112280-518030