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��� -`4 � <br />�� �.. � <br />City of Rqs�vi2le <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, �VI.�V 55113 <br />(651) 792-7034 <br />Recycling Hauler License Application <br />Fee Due: $125.00 Year `� ���� (License will he far January � to December 31.} <br />Business Name ��, � f�:r � � :� �✓ � � � ��f �'. �� � � }�� � ��_�.•�_- � � �y <br />—�� <br />Business Address c✓ tP iL? � � ,� �y � � � 1 V �r L��� � � i;J �� <br />Business Phone � � � � �'� +, �„ <br />Contact Person �� e 7l-7 �1,�����;n:i i i Address <br />Emergency Contact lnfarmation <br />If completed license should be mailed somewhere other than the business address, please attach separate sheet. <br />Recycling services will be provided to (checkal� that apply): <br />_�J��xiJcnrial � {'���uycrr i�l � �i�Flrifa�fl � � Fnd��:ra,�� <br />Number of vehicles the applicant proposes lo use in the collection ofrecyclables <br />Name and address of companies ar materials recovery facility where recyclables will he delivered: <br />Newsprinf* Glress * Cans/PIaSEic * <br />•-- --_. r�v <br />����� � ...�� ��� ��. -.. . .—{_ —.. � �—.._ — — — <br />� � � ����� �� � <br />��� � �i� � ��Y r - , <br />��'�_c �,i.µ.�x•�asFj�x�r� + � �'�rru,y.�cd Larabo�:i' ���cr��ic�x.rr�oec•_l}� <br />�� � f � � {� <br />*Required items for residential and multifamily haulers <br />I have been provided with a copy Af the City of Roseville Cu�'bs€c!e Recycling Ordinance 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 attac� a certificate of liability [ns���sns�, a � ' f j �r i-�dic7r��� �Fi r = f'rn .e��arion coverage, and the fe �$125.00. <br />i l!, �. / l) .-- <br />i � � (fJ �� �_✓ � <br />Date . �ii�� �Gi � �'7�(� <br />