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City of Roseviiie <br />Finance Departmentq License Division <br />2660 Civic Center Drive, Roseville, <br />(651) 490-2212 <br />Recycling Contractor License Application <br />Fee Due: $125.00 Year &D-QL>-Lk (License will be for January 1 to December 3l.) <br />Business Name CAP, gF,\ Mez, <br />QLQJC\. :Una. <br />Business Address � S <br />Contact Person Business Phone <br />If completed license should be mailed somewhere other than the business address, please advise. <br />Recycling services will be provided to (heck all that apply): <br />Residential IV� Commercial <br />Mulrifamily hidusti-ial <br />Number of vehicles the applicant proposes to use in the collection of recyciables <br />Maitre and address of companies where recyclables will he marketed: <br />Newsprint Glass Cans <br />—Owc!-�-L QC, <br />Plastic Corrugated Cardboard Other- lease specify) <br />.�. _ <br />I have been provided with a copy of the City of Roseville Curbside Recycling rd <br />� � � Inance (available at <br />www.ci-roseville.mn-us/adrAWeltycodelch403.txt) and understand that violation of any oft he provisions ens in� <br />clnded in the ordinance may result in suspension or revocation of tie license. <br />i have attached a certificate of liability insurance, a certificate indicating Worker er CoFnpensafion coverage, and <br />the fee of $125.00. <br />Applicant's Signature <br />Title <br />., <br />Date <br />