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�� 1 _ J � / <br />� � <br />,.y..� <br />Finance Department, License Division <br />2b60 Civic Center Drive, Roseville, MN 55113 <br />, (651) 792-7036 <br />Recycling Hauler License Application <br />Fee Due: $125.00 Year �f� L`�'' (License will Ue for January 1 to December 31.) <br />Business Name <br />����.'s � � � r��.�:. I ���,�-��r� � � ���° � <br />Business Adc�•ess <br />Business Phone ��' � <br />� <br />� <br />Contact Person � � � � � �. "' ��r ��Ei�� Address �..1i� � � (,��- � �1��"�-�j�`I� ` � <br />; <br />'�"�" ' <br />Einergency Contact Information � j� "_"' ��` � � '� � � � I � � �''�� � � �� " �,�"' � �� <br />If completed license should be mRiled somewhere other than the business address, please attach separate sheet. <br />Recycling services will Ue provided to (checic all th�t apply): <br />�esidential .�Conm7ercial ,.�Iultifauiily �ndustrial <br />� � � � <br />Ntunber of vehicles the applicant proposes to use in the collection of recyclaUles <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />Netivsp�-int * <br />� <br />� <br />ce �apei�/Boxbo�srd* <br />Gla,ss * <br />� r <br />Cor�rugated Cai�dboard * <br />*Required items for residential and multifamily haulers <br />I have been provided with a copy of the City of Roseville Curbside Recycling Ordinauce and <br />provisions included 'ul the ordinauce may result nl susp��yion or revocation of the li�se. <br />�. <br />Cans/Plastic * <br />OtheY(please specif}�) <br />�_ � � <br />tand that violation of auy of the <br />I have attached a certificate of liability inswance, a c rtifi ate indicatii g ork Compensatio overage, aud the fee of $125.00. <br />�'��-����� � <br />D1te AE licant' Signahire itle <br />