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��� -� <br />��� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, N� 55113 <br />(651)792-7034 <br />Recycling Hauler License Application <br />,. ._ -- _. _. <br />Fce Due: $125.00 Year - (License will be for January I to December 31.,) <br />Business Na€ne <br />Busi�ess Address �� T 1' I S A N i T A i i 0€� 1 N C. <br />t7Z5 MEADOW Ul�W RpAp <br />Business Phone F��� u r� . , <br />�. <br />Contact Person � ti-+ rr� �'�" r �rr�ai� Address _ —__ <br />Emergency Contact Information <br />If completed license should be mailed somewhere other than the business address, please attach separate sheet. <br />Recycling services will be provided to (check all that apply): <br />R���i9r.r.li:d � �;nrnnisr�ial �[ ?Miuli•.r�rnilv Il1d;5Ff'l� <br />Number of vehicles the applicant proposes to use in the collection of recyclables <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />Newsprint � <br />—��r� •�- ;_ t- �.� � <br />��. �� �� <br />Office paperlBaxbaard * <br />� :� �� �� <br />CH�� <br />Corrugated Cardboard* <br />��� •��� <br />*Required items for residential and multifamily haulers <br />Cans/,Plast�c * <br />Other(pLease spec�} <br />i have been provided with a copy o f the City of Roseville Curbside Recycling Ordinance and understand that violation o f any of the <br />provisions included ir� the ordinance may result in suspension or revocation of the license. <br />I have attached a certificate of liability insurance, a certificate indicating Worker Compensation coverage, and the fee of $125.00. <br />� � ������- �2� . <br />]3 � Applicant's Signature Title <br />