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��� -� <br />��{� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville,lV� 55113 <br />(651) 792-7034 <br />Recycling Hauler License Application <br />Tee Due: $125.00 Year ��� (License will be for January 1 to December 31.) <br />BusinessName i���.t�' ����#��� ��. <br />J / <br />BusinessAddress ���'�����°� ��+r �� ������ +�� �}���� <br />Business Phone ,�/ ��� f� f�� � <br />Contact Person ��r�i � E�aGI Address _; <br />, _, � <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 (checic all that apply): s <br />,� � �� � � �{�+� ���� . <br />Residential Commercia3 �Multiiamfly�i��dust.r#ni <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 />O, ff ce �aper/13oxhnard * <br />Glass * <br />Corrugated Cardboard* <br />*Required items for residential and multifamily haulers <br />Cans/Plastic'� <br />Other(please speei, f,y) <br />I have been provided with a copy of the City of Roseville G�r6side Recycling Ordinance and understand that violation of any of the <br />provisions included in the ordinance may result in suspension or revocation of the iicense. <br />I have attacheda certificate of liability insurance, a certif'icate indicating Worlcer Compensation coverage, and the fee of.� P? i�.f1�1. <br />�� T � Y� � ���� —„ _ — ��� . <br />Date Applicant s Signature Title <br />� <br />