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T Y <br />V 1j-1 -j <br />Finance Departm,e,nt, License Division. <br />2660 Civic Unter Drive, Roseville, MN 55113 <br />(651) 792,-7036 <br />V <br />Siolid Waste Hauler License Application <br />........... <br />M <br />Fee Due: $125.00 ar �,,c License will be for January I to Decern-ber 3 1.) <br />Op"N a M-- <br />Business Marne 15POShL S 9VICC A] <br />Mftv�A <br />Business Address <br />Business Phone <br />Contact Person i 15A W1 �L- E , --- <br />L L .TIVE9 <br />Errs all Aiddress, <br />Emergency Contact Information <br />If completed license should be mailed somewhere other than the business address, please advise. <br />Sohid waste collection will be provided to (check, all that apply), <br />>( Residential (sing,lie, family, duplex, triplex, fourplex) <br />Multiple Residential (apartment, condominium, manufactured home park, and townhouse) <br />> 11L <br />( Commercial/Industrial <br />Number of vehicles the applicant proposes to use in the collection of solid waste <br />Name and address of disposal or recycling facilities to which, waste will be hauled: <br />Garbage Yard Waste <br />Brush <br />f5x fi <br />Additional Items such as appliances <br />�(allach ad (fill onal sheet if necessarj)) <br />