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j��N� <br />i �,� � <br />Finance Depawtment, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-703G <br />Recycling Hauler Licen�e Application <br />Fee Dve: $1ZS.Q0 Year �`�'i (License will be for 7anuary 1 to December 31,) <br />Business �Tame � 1�7 1 i r�� <br />Business Address �9�I. � Y� � � �� ��� I � ` �� ��� � <br />Business Phone ��7 l"��' � 7`�" l� _ <br />Contact Person �� ��1'�.`.x�� .__._ �mail Address <br />Emergency Contact Information 1��� I r rl��.'�"i�' � <br />If completed license should be mailed somewhere other than the basiness address, please attach separate sheet. <br />Recyaling services will ba provided to (check all that appiy): <br />�Residential �.Commercial �Multifamily [�Industrial <br />Number of vehicles the applicant proposes to use in the collaction of recyclables <br />�� <br />Name and address of companies or materials recovery facility where recyclables will be deiivered: <br />l� c . - r�'1'�v�i�nt �-r' � . Gl � * <br />� r v.� r,�� � <br />�L� �i� �--�/����L � <br />�1�, ���� �i� <br />O�ce paper/Boxboard* Carrugated Cardboard* <br />. � <br />�`Required items for residential and multifamily haulers <br />I have been provided with a copy of the City of Roseville Curbsida Recycling <br />provisions included in the ordinance may result in suspension or revocation of <br />I have attached a certifccate of liability <br />_. � � — rc�— i� <br />Date <br />Appli <br />Cans/Plastic * <br />� <br />Other(please spec�) <br />I <br />and understand that violation of any of the <br />Compensation co�erage, and the fee af $125.00. <br />