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:j <br />is <br />� �, <br />/i <br />..r. <br />fi <br />ar <br />r.: <br />' /,i <br />r:�` <br />j y' H. <br />,= <br />;:r <br />1T;, <br />�,, <br />��'�,��' � , � �'t� <br />Fina�ace Department, License Division <br />2660 Civic Center Drive, R.osevilie, MI� S5� 13 <br />{G5i) 792-�a��a <br />Salid W�ste Hauler License Applica�ian <br />Fee Due: $125.00 Year �� (License wili be for January 1 ta Decetnber 31.) <br />l3usiness Nar�e �� � `�]����� � ` <br />/� j���+� � q <br />I3usiness Address �°'I �� ��� ����.� , � � 1 �9� ��3����� ��3� d �' <br />I3usiness PhQne i�i 1 � ` �� "' �� � <br />Contact Pcrsc�n �� <br />,, � <br />Bmail Address <br />���r � <br />! /"?r <br />Emergency Contact Infor�natian � "` ��� <br />I�' cott�pleted license s�tot�ld be mailed somewhere otlter fihan fhe busiz�ess address, p�ease advfse. <br />Solid waste coliection will be provided to (check aIl that apply): <br />� Reside��tial (single family, duplex, triplex, fourpfex) <br />� Multiple Resiclential (a�artment, eondom9=�iurr�, manufactured ho�ne park, and townhouse} <br />� Coinmercia�l�ndr�stria] <br />IVumbe�• oivehioies the app�icant praposes ta use in the eoliection o�'solici waste � <br />Name and address of dispasai or recycling facilities ia which waste will be }sauled: <br />GarGnge <br />Bruslz <br />� � ���1,�1 ��I � <br />Yarti Waste <br />Arl�ztianal Itenzs suelz as ap�liruaees <br />(aftach adrlitio�znl sJieet rf necessnry) <br />