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E Finance Department,License Division 2660 Civic Center Drive,Roseville,XW 55 113 (651)792-7036 Solid Waste Hauler License Application Fee Due: $125.00 Ye& 07WAo (License will be for January 1 to December 31.E At - 9- Business Name Bu s Address � s m es If completed license should be mailed somewhere other than the business address,please advise, Business Phone Contact Person I 4Fr 09 (Business Matters) Email Address Contact Person r _do (operational Matters 7r Email Address Emergency Contact InfortnatioT Contact Name: Cell Phone: Alternate Contact Information; f- _ In the event that,while operating in Roseville,a collection vefiicle leaks 4r spills either vehicle fluids or fluids or debris from material collected the company must contact the City within one business day with information regarding the material involved,the amount of material involved and the steps taken by the company to mitigate and remediate damage.This contact does not absolve the company from liability. The City expects that in the case of a natural or man-made disaster or a public health crisis your company will be able to continue service.Your company should plats for c ntinuity of operations through an emergency operations plan.Does your company have an emergency operations plan" "Yes No Your company must notify the City when you activate your emergency operations plan,and inform the City of relevant information regarding provision of collection service under the plan. Solid waste collection will be provided to(check all that apply): 00 %'Z�O Residential(single family,duplex,triplex,fourplex Multiple residential(apartment,condorniniurn,manufactured harm park and townhouse) Comm=ialllndustrial Number of vehicles the applicant proposes to use in the collection of solid waste ZL X�J%' ze i (over)