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City of Roseville <br />Finance Department, License Division <br />2 660 Civic Center Drive, Roseville} MI 55113 <br />(651) 490-2212 <br />Recycling Contractor License Application <br />Fee Due: $125.00 Year rrlbot (License will be for Jams 1 December <br />� to 3l.) <br />Business Marne <br />soltj WM-T'e"' <br />Business Address 6 Ct Ca' MWLOO <br />ET. V+' I <br />01. �sf 0 S <br />Contact Person JAA I W � , r'-e Business Phone <br />If completed license should be mailed somewhere other than the business address, pease advise. <br />Recycling services will he provided to (check all that apply): <br />Residential <br />Multifamily <br />K Commercial <br />-, hidustrial <br />Number of vehicles the applicant proposes to use in the collection ofrecyclables <br />hone and address of companies where recyclables will be marketed. <br />Newsprint 62- Glass Cans <br />C' laxl& + 8 I <br />1T- <br />vq�-4 POOL, <br />Plastic <br />Corrugated Cardboard <br />(�oc.,L Tek, <br />Other- (please specify) <br />I have been provided with a copy of the City of Roseville Curbside Recycling Ordinance available at <br />www. ci. roseville. mn.us/adniin/citycode/ch4O3.txt) and understand that violation of any of the p rovisions hi- <br />eluded in the ordinance may result in suspension or revocation of the license. <br />1 have affached a certificate of liability Insurance, a cerfifisate indicating worker Compensation coverage, and <br />the fee of$1 5.00. <br />App ' 's signature <br />Tale <br />Date <br />