Laserfiche WebLink
j�%-���.. � . ------- <br />� <br />Finance Department, License Division <br />2660 Civic Center Dr�ve, Roseville, MN 55113 <br />(651} 792-7036 <br />�l � <br />� �� <br />��� <br />0 <br />Recycling Hauler License Application <br />Fee Due: $125A0 Year � f� {License will be for January 1 to December 31.) <br />Business Name F-� 10��i�'�i �'f�Cl D�`� <br />Busi..css �.3drsss 1 �' �' '�J � <br />����. <br />�'� FJ <br />Business Phone �� ` ��J � -- �� � - <br />Cantact Person �� � �� Email Adciress <br />_ , � <br />Emergency Contact Infarmation 1'1O�Y''�` � 1� �- <br />If completed �icense should be mailed samewbere other than the. business address, please attach separate sheet. <br />Itecyciing services wi[E be provided to (ct:ec[c all that apply): <br />❑Rasidential ❑Commercia] �Multifamily ❑Industrial <br />Nwnber ofvehicles the applicant proposes to use in the collection of recyclables _ <br />Name and address of campanias or materials recovery facility where recyclables will be delivered: <br />Newsprint* <br />O�ce <br />Glass * <br />- � `�, <br />� <br />*Reyuired items �r residential and multifami�y <br />Corrugated Cardboard* <br />Carts/Plash'c * <br />��� : ,.�, � -- -- <br />� <br />� .,� <br />5 , <br />, <br />Other(please specifyJ <br />I have been provided wifh a copy of the City of Aoseville Curbs�de Recycling Ordivance and understand that violation of any of the <br />pxovisions included in the ordinance ir�ay result in suspensian or revocation of the license. <br />I have attached a certificate of liability insurance, a ificate indi � Worker Compansation coverage, and tttie fee of $125,OQ. <br />1� lg /3 � <br />Da e Applicant's Signature itle <br />