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'��f,�., �"�" 1 " _..�..._��.�.� <br />� <br />Finance Deparfinent, License 1Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(G5I) 792-7034 <br />Sc��id Waste Hauler Lieense App�ication <br />Fee Due: �125.OQ 'Year ���..,, (License witl be for January i to December 31.) <br />�3usincss Name <br />E3usiness Address <br />tsuscnass t'�c�ne [v-� r - .., ,� ar ✓ t <br />_ n f, . . , <br />Contact i'ersnn <br />Gnaai[ �ddress <br />Emcrgency Contact IG�for�nation ___ __,�__... . .' . � —� <br />v <br />�i' cnmpletied iicense should be mailed somewhere o�her than the b�sin�ss address, ptease advise. <br />Solid wastc cotiaction wi�l be p��o�ided to (ch�ck aIl that apply): <br />� Residential (single �'amity, duplex, triplex, fourptex) <br />� Multiple Itesidential (apartment, condornini��rr�, rr�anufactured home parlc, and eownhouse} <br />�''� o n� rr� e�•cial/Tndusirial <br />.� <br />Number of �ehicles the applica��t praposes to use in the caileclioi� of salid wast� �� <br />Name and address of dispflsai or recycl€ng facilities to wh€ch waste will be haulecl: <br />Garbage Yard Wnste <br />; f �1.� G�: � I�� ' �' �'� ����L�-t��"Yt �,� � �1�'c"��"` (.�aLd'r` ��� <br />� <br />j s� „ I7!'� . i _ _ .�i n . , <br />�drlitianaf 1'tems such us appliafzces <br />(attaclz �d�lrttnnal sheet if necessary) <br />