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j�� <br />�.� <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7036 <br />Recycling Hauler License Application <br />�, .. , _� <br />Fee Due: $125.00 Year _/'L ��_� (License will be for January 1 to December 31.) <br />/� i �--� <br />Business Naine l _tf�'�� ( �%'�i��c �� � �--- I `�L�i'�1�,� � ���" �L �l ��C`_ �� <br />� �� " � �, , / . - <br />BusiuessAddress ��L-�� I ���/"�l( r��/� ��-� "�(:J( ��'l �� � ����C�-_� <br />Business Phone ��'�7 � � ��� �- � ��� ��" <br />,: � �) <br />Contact Persoil ��C � %�11"l-`�/'%�� Email Address ���K-��r • �� ��11 `�''��1��"� ��/:t��C�c�Ji 5�'����'� <br />� <br />Emergency Contact Information � �� C� �['� �� /� 1 �-� °� <br />If completed license sliould be mailed somewl�ei•e other than the business address, please attach separate sheet. <br />Recycling services will be provided to (check all that apply): <br />�]Residential �jC]Commercial [�Multifamily [�Industrial <br />. <br />Number of vehicles the applicant proposes to use in the collection of recyclables `i--� <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />�,� �� s� IIry��I�r ���r,���� <br />� �C,� C � �i ��" ��c�lcti}���� �7/ <br />, <br />/%'1�/ � . ���.? ���//"'� <br />.--�-.--, <br />Offrce paper/L3oxboard* <br />Glass * <br />t� <br />Co�-rz�gated Cardboai•d* <br />*Required items for residential and multifamily haulers <br />Cans/Plastic * <br />�, <br />Other(please specify) <br />I have been provided with a copy of the City of Roseville Curbside Recycling Ordinance and understand that violation of any of the <br />provisions included in the ordinance may result in suspension or re�ocation ofthe license. <br />/- <br />. <br />� <br />I have attached a certificate of liability insur ric .�a certi� �te indicating Worker Compensation cover•age, and the fee of $125.00. <br />J' - � � ��� > /�I i/�;l"y/� ", C� %;�.%� <br />Date �_...— �tLp�lf nt's Signature Trtle <br />