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L���. <br />��� . <br />Finance Departrnent, License Division <br />2660 Civic Center Drive, Roseville, MN 5511.3 <br />(651} 792-7036 <br />Recycling Hauler License Applicat�.on <br />Fee Due: $125.00 Year (� � (License will be for January 1 to December 31,} <br />Business Name �, .� ./,��j,�g��f ��� rV1 /'?l'S� 'f`�e. � 1I? G <br />Business Address ��� � (� ��� � ,�j f' J� � ��(,���,p, � %7 .'rj�j i <br />Busi�essPhone ��(�� ° ��� ° J��3� <br />Contact Person ���1�(a�Y`/ �.Q�� �J�� �j �mail Address ,_ <br />��i� n <br />Emergency Contact Inforrnation <br />Ff complated licensa shouId be mailed sarnewhere other than the business address, please attach separate sheet. <br />Recycling services will be provided to (chack all that apply); <br />�Residential �Commercial �Multifamily �Indusirial <br />Number of vehicles the applicant proposes to use in the collaction of recyclables � � <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />.News ri t� Glass* Cans/Plcrstic* <br />L,�I] �Yl��'j u � l �I �i � � �YJ1 �' � � .�1? �ryh.pT, <br />] f1 d Ya a <br />�� 1 s YY� Y�._ �_ 5�13 <br />��ce paper/Boxboard* <br />��Q��� . .� <br />Corrugated Cardbaard* <br />t • �� <br />�Req�ired items for residential and multifamily haulers <br />Other(please spec�) <br />I have been pravided wi�h a copy of the City of Roseville Curbside RecycIing Ordinance and understand that violation of any af the <br />provisions included in tha ordinance may result in suspension or revocation of the license. <br />I have attached a certificate of liability insu c a certi te indicating Worker Compensation coverage, and the fee of $125.00. <br />la-�G�-l� i a <br />Date Applic t's Signa Title <br />