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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490 -2212 <br />Recycling Contractor License Application <br />Fee Due: $125.00 Year (License will be for January 1 to December 3 1, <br />Business Name lvoemo'e W'4s-fs L'5'moij . <br />Business Address 32cll - 6-em rivn& bg <br />Contact Person e 'I Business Phone be 67 - &F& --- - ~7 <br />- WA Vw If completed license should he mailed somewhere other than the business address, please advise. <br />Recycling services will be provided to (check all that apply): <br />Residential Y Commercial <br />Multifamily X Industrial <br />Nwnber of'vehicles the app licaw proposes to use in the collection ofrecyclahles <br />Nance and address of companies where recyclahles will he marketed: <br />Newsprint <br />f- c elewv <br />A 7 . i <br />IPM 6m#AVvrR6 <br />Plastic <br />Glass <br />Corrugated Cardboard <br />iF1 ? eA rk �'� V e, 4146 fj&lal __�4 OW C <br />dr j:/ <br />M <br />Calls <br />Other (Plea-se Specify) <br />1 have been provided with a copy of the City of Roseville Curbside Recycling Ordinance (available at <br />www.ci-rosevllle-rnn.usladniWcitycode/ch4O3.txt) and understand that violation of any of the provisions in- <br />cluded in the ordinance may result in suspension or revocation ofthe license. <br />l have attached a certificate of liability insurance, a certificate indicating Worker Compensation coverage, and <br />the fee of $125.00. <br />11L) <br />Applicant's Signature <br />TWO <br />t /o -'� <br />Date <br />