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2003_1124_packet
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2003_1124_packet
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11/2/2011 8:52:45 AM
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10/19/2011 1:00:58 PM
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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 �G (License will be for January 1 to December 31.) <br />r % �/ C <br />Business Name � � i ��/� [f / � f_' --1_.� <br />Business Address -� � � � Lbo(e 9Z Y�2 N.- <br />//1/jW IfiAl. 5'0'0 <br />Contact Person 4r -` 1�r 6 R - <br />_ P-11" Business Phone -- <br />44C 6 04 r 2 dJ; <br />If completed license should be mailed somewhere other than the business address, please advise, <br />Recycli zig services l"ll he provided to (check all that apply) <br />Residential Coimnercial <br />lulti&nifly hidustrial <br />Number of vehicles the applicant proposes to use in the collection ofrecyclables <br />Name and address of companies where recyclables will be marketed: <br />Newsprint Glass Cares <br />Y z (f 4: V 6 , / e, q - t ps r C" <br />Plastic Corrugated Cardboard Other (please specify) <br />x do <br />47 4: V (� /i ly <br />I have been provided with a copy of the City of Roseville Curbside Recyclilg Ordinance (available at <br />�vww.ci.roseville.mn.us/admWcitycode/ch403.txt) and understand that violation of any ofthe provisions in- <br />cluded in the ordinance may result in suspension or revocation of the 1 icense. <br />I have attached a certificate of liability insurance} a certificate indicating Worker Compensation coverage, and <br />the fee of $125.00. <br />plicant's signature <br />Title <br />Date <br />
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