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R1�� <br />1�� <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, �IN 55113 <br />(651) 792-7036 <br />Solid Waste Hauler License Application <br />Fee Due: $125.00 Year �\�o (License will be for January 1 to December 31.) <br />BusinessNaine �Q1�Ci��� �aQ11� T��i<<%�i �I�iC'_ , Li�r� , �Qi1�U, �� EIl1lil�i?i'1YY)���� IC�.� ��1-L�iL� <br />., 'I , � � ,� S-5:.�,�� <br />Business Address � L} �'� C% X � l-, �� '-i�-3 � � �� • `7 , NI;. �/ � % _ � �. �� ICt1' (, .I � j �`' - <br />If completed license should be mailed somewhere <br />Business Pllone �%� �� � � �, - 3 � j-� <br />Contact Information <br />Business i�tatters <br />Operational Matters <br />Contact Person �� t; t1r�1 Q ��C� ��.�- <br />than the business address, p <br />Email Address Y' �(� � E IP �^ 1" Ll �\ �:� �I % 5 �� r1 i�i� � i G'?"1 � L �'�� <br />Contact Person .� CC,�'N � <br />Email Address <br />advise. <br />Emergency: Contact Nanze: ��t'1 � C�� f� �,�: � C>� � <br />� <br />Cell Phone: � �� 1 �� ) � � �� � �-� -� -� � <br />In the event that, while operating in Roseville, a collection vehicle leaks or spills either vehicle fluids or fluids or debris <br />from material collected the company must contact the City within one business day with information regardine the material <br />involved, the amount of material involved and the steps taken by the company to initigate and remediate damage. This <br />contact does not absolve the company froui liability. <br />The Ciry expects that iu the case of a natural or man-made disaster or a public health crisis yolir company will be able to <br />continue service. Your company should plan for continuity of operations through. an emerQency operations plan. Does your <br />company have an emergency operatious plan? Yes �No Z� �- � t 5 �-' �`'� � � �"�`� ' n'�� ���� �^' � � K( y' <br />, <br />�r������� c�s s� �����-��r �I(uw�_s . <br />Your company must notify the City when you activate your emergency operations plan, and inform the City of relevant <br />inforination regarding provision of collection service under the plan. <br />Solid waste collection �vi11 be provided to (check all that apply): <br />�� ��� Residential (single family, duples, tripLex, fouiples) <br />I/ Multiple Residential (apartment, condominium, manufactureci hotne park, and townhouse) <br />� Cominercial/Industrial <br />Number of vzhicles the app(icant proposes to use in the collection of solid �vaste <br />(over) <br />