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�� � <br />�!-�- � . �, �� �� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, NIN 55ll3 <br />(651) 792-7034 <br />Recycling Hauler License Application <br />Fee Due: $125.00 ��,7° ��� � � I�.s 113'L' W I�I 'JL' <br />Business Name . .�{r��'�-�� � � �� � <br />Business Address ��.� � , �� � � <br />f �� <br />Business Phone _ { � ____�+'��,`� �' � �� <br />Contact Person <br />J,LIIV711�' � kU LKL'CI71:1L'C } �.� <br />,. . � <br />Ema€E Address <br />� <br />� <br />�' <br />����' ������ �r � _ �� � ��. . <br />Emergency Contact Itzforrnatio � _ <br />� <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 />_ ���i?t.ti[rsP �C:nr�r�t::l °_I_ .. ..1�i�'r!�h�!��-- -'r 1r���1� <br />Number of vehicles the applicant proposes to use in the collection of recyelables <br />Name and address of companies ar materials recovery facility where recyclables will be delivered: <br />'r i�•r��in� * f i?Sfi � W �'i.is� � C* <br />��- � � <br />�� �'� � . _.., �-����----- —� �� - <br />� � �- ��� <br />pffice paper/Boxboarrl * Corrugated Cardboard * Other(pCease specify} <br />ti��`t.��_ �� r�/11��`� ��� €�� ��1� <br />*Required items forresidential and multifamily haulers <br />I have been. provided with a copy of the City of Roseville Ct�rbside Recycling Ordir�anee and understand that violation of any of the <br />provisions included in the ordinance may result in suspension or revocation of the license. <br />1 have attached a certificate of liability i�7s'•�r�nc� $ ccr[� �[��a �r� icnS�� ti' k�r npr�isation coverage, and the fee of $125.00. <br />�� ��'�'��- � ��� <br />[J�it �{ A�i � I ISIFC � Title <br />