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���'� � <br />'� _ . .., :. <br />� �� � � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Rnseviile, �N 55113 <br />(651)792-7034 <br />Recycling Hauler License Application <br />Fee Due: $125AQ Year ��� (License Wi�2 � for January 1 to December 31 } <br />BusinessName���rd�o�iustnf �'eJS� __ - <br />Business Address � 0. �� fa? �r���- L a �5� �{{ <br />Business Phone 7f+�'7��" �'��� <br />Contaat�e��sor� �ULtc. �E��.��;� EmaitAddress <br />Ifcompleted license should be mailed sa�ewhere other than the business address, please attach separate sheet. <br />Recycling services will be provided io (check all that apply): <br />� J2 s�iclr.�rizl �.. t'nrr_rc:rrt�ial __�+J_ill i 3i'i: iJ:�917�:1s1� i51 <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 />�•C'W:�'� :rlf + �-i�; jF � f��3'�� ��ftlt � <br />�.i�{ = �1��I�n] k��al��lkr�i� �i�Ri4►�"�� ._.. � <br />��ee na4atr:'�eu����irtf � <br />�'d'_'��= _�'�?' ��,d._ <br />L'c'�" �i��lit'��?�{IfiIS�'Ji+�+ <br />����4''-a�� -- —� — <br />*Required items for residential and multifamily haulers <br />�f:ir� �'fr, lS yGJG C•�L�7 f: t• J�.+ <br />�E} L�e� � ����i r �t <br />S�� �i,e�� <br />I ha�e been provided witkz a copy o� the City of Roseville Curbside Recycling Ordinance and understand that violation of any of the <br />provisions included in the ordinance may result in suspension or revocation of tl�e license. <br />1 have attached a certificate of liability �_;�t; di_��. 3 ttYi,;±'��'t i,��t�::iag Worker Compensation coverage, and ��ae fee of $125.00. <br />���� <br />��bk ppl=enr�' S �I�nr�luf+� Title <br />