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,�� � �� . , <br />� �__.... ,.,.,.,..,-�' . _ ��_� <br />�'inance I3eparimenf, License Divasii�rz <br />2660 Civ�c Center Drive, Roseville, iV.CI�T 55I13 <br />(fi51) 792-7034 <br />�al�c� 'VVa�ie Hau�e� License Appli�at�on <br />Fee Dt�e: $125.00 Year��� �_ (License wi31 be for.Ca�y��ary 1 to �7ecember 31.) <br />k3usistess Na�nc �{p E�� qpi � at r� q4 E L n n n R 9 <br />_ � i' �7 kl""1-E�I 1F �e—�7 C�T'ff3 H t. <br />B�siness At#dress � � � � � � � � � � � � � � � � <br />� �� ����1 _ <br />Rusiness �'hone � , � � � <br />Contact Person �3 � � T�1 <br />Etnait Address <br />.. _ �. � . , <br />Enzergency Contact Info�•n�atio:� <br />If comple#ed license s�rould be mailed somew�ere Qther �lian the business ac�dress, �alease advise. <br />Salid waste collectifln will be pro�idect to (check all that apply}: <br />� Itesidential (sing3e family, dupicx, triplex, fourpiex} <br />MEilYiple Residential (a�artment, condor€liuium, manuiactured honae par(c, ai�d townhous�} <br />Cammercial/In�1 usTriaf <br />i�i�unber of vehicles ttse a�plicant prnposes to use in Yhe coilectio�� of solid waste <br />l�iame and address of dispasal or recycling facilities to wt�ich waste will be haiiled: <br />Garbnge ""'w--� Yard WasYe <br />Brusla �irCrlitio�ialltcros suclz as appllrrnces <br />(attach adc�itionrcl slaeet if necessary) <br />