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�4�� � <br />��-�. <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, �T 55113 <br />��r�I} 792-7034 <br />� ���i� Waste�Hauler License Application <br />Fee DUe: �125.00 Year c�� ((License w�ll be for January 1 to Deceinber 3I.} <br />r � <br />1] u.ttntpM �]enit _ �� �] �� C{�7 r f� ltr � �? � �'�_C_ _ <br />]1d3�Rrei�,�d�lr{ss � � �,�J` � � � _ _ .��� }I� �J �� � � <br />A�sifI�C55 PF1S�ne � r � � J 1 �c� -�� � -.J <br />I <br />��o[a�r Rr-san _� F�'s7 ri� ~ .� � ' �� .- --- —• •- <br />�mail Address <br />Einergency Contact Infonnation `� ;,F �~. � U <br />If completed license should be mailed somewhere other than the business address, please advise. <br />Solid waste collection will be provided to (check ali that apply): <br />_ Residential (single fainily, duplex, triplex, fourplex) <br />� Multiple Residential (aparhnent, condoininiuin, inanufactured hoine park, and townhouse) <br />� Co�nmercial/Industrial <br />Nuinber of vehicles the applicant proposes to use in the collection of soiid waste _��r <br />Naine and address of disposal or recycling facilities to which waste wifl be hauled: ----- <br />Garbage Yard Waste ��� � _ - <br />��� �������� � <br />Brush Additional Items suclr as appliances <br />(attach additional sheet if necessary) <br />