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��� <br />� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Recycling Hauler License Application <br />Fee Due: $125.00 Year ��� (License wall he for January 1 to December 3�) <br />Business Name ��� ���'�''��'�� � �1_L�� �� �_. _ . �t .��.�}'� �" � <br />Business Address <br />�� � <br />Business Phone � � � ' ��� ���� ��� <br />Contact Person �T���¢��„ Emai� Add <br />----� <br />Emergency Contact Xnfprz�aiion �� ����}'���� f '_���"��� <br />If completed license should be mailed somewhere other than the business address, please attach separate sheet. <br />Recycling services will he provided to (check all that apply): �� � f��� �� �� ������-� <br />R e s i d e n t i a 1 Gamtnereial Muitiiamily Indus � ia] � ���s�� <br />�� �'�� �,U� t�/� ���. �t�.��r� { <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 he delivered: <br />* <br />Newsprint <br />Dfftce pape�Boxboard * <br />Glass <br />* <br />Corrugated Cardboard* <br />*Required items for residential and multifamily haulers <br />i�� ! ��� <br />Carzs/.f'lastic * <br />Dther(please specify) <br />I have been provided with a copy of the City of Roseville Curhside 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 />I have attached acertificate of �iabil3t}• �*m�!i w a _.,. [ afi.ing Worker Compensation cot��t'��,�, �i;l ��� �: � i��_��i. <br />y +�-'=-��• <br />—����—�� i4� c•I_��–�_•'� •� � _ �" d�F "' <br />Date pli 's�. � ��— .i'+� � <br />�� I� <br />