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Fee Due: $125.00 <br />Business Name <br />���� �1 <br />��� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville,lVlN` 55113 <br />(651) 792-7034 <br />Recycling Hauler License Application <br />Y'ear �-� �� (I,icense will be for January I to December 3 L} <br />��' i ��i�1�'�t L�r1C•:� � f�r�rr ��� �t L srtn �� I�r�i' ���!'t`� � ���R�-� ��i <br />BusinessAddress � ��� �����cxr� _�_s�� :� <br />Business Phone r � � �� � � � � <br />�-•- • �---. � - . <br />Contact Person j� � s ��� �� ��� Emai1 Address _. <br />F !.-, <br />EmergencyCoz�taatInfnrmatio�: �' <br />- - - - - � ' � <br />Ifcompleted license should be mailed somewhere other tk€an the business address, please attach separate sheet. <br />1��y�r�� xe.-�i�� w �][ �. pi �4�ida�t i�, �tlw:�k $Tl i��i �F?�Y�- <br />� � � <br />, �! E��x�r,i i$I � �r�rn�rct�3��.+�Jti11 if,�i]�� advakri�E <br />Number of vehicles the applicantproposes to use in the collection of recyclables � <br />Name and address of companies or materialsrecoveryfacility whererecyclableswill be delivered: <br />Newsprint* <br />�'�?Jk��ti �+��__ t�yr �, .7 �} <br />� <br />O�ce paper/Boxboard* <br />�c�r���:__ ��.���� .._ <br />Glass* <br />���C ��� �' � c.•� L 4 � �l <br />•��--- --• � <br />Corrugated Cardboard* <br />� �r� f i � �_ ��.� ��-�_� <br />*Required items for residential and multifamilyhaulers <br />CansJPlastic * <br />--������, � ����r�r <br />42her(please specify) <br />I have bea� provided with a copy of the City of Roseville Curbside Recycling Ordinance and understand that violation of any of the <br />provisions included i� the ordimauce may resultin suspension or revocation of the license. <br />I have attached a certificate of liability iusurauce, a certificate indicating Worker Compensation coverage, and the fee of $12S.fl0. <br />�i.lf I„ � ' 7J� �. . . � I�L'��.� � � 4 � : <br />�t� 1 p�lr;�d'� S]�n�hl[� 1L1�G <br />�� <br />