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2004_1011_Packet
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2004_1011_Packet
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�� <br />�� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490-2212 <br />Recycling Hauler License Application <br />T+ee Due: $125.00 �l��d ` (Licensewill be far January 1 to December3l.) <br />�usan.�s h�ain� � ����.,.� V�.���-� �� � �. � � � ���� <br />� <br />Busiirtss A�dr�ss ��� ,� _ � �� � �'"�� , <br />_��� �� �-�. , �� , � .�~r � � <br />ContactFer�or�� t �4�� � ���,��lSk Business Phone �� � � �' °��'� <br />�6,.Y � �� • �.� � -� � �� <br />If completed license should be mailed somewhere other than the business address, please attach separate sheet. <br />Recycling services will be provided to (check all that apply): <br />� Residential �� Commercial � Multifamily � �Industrial <br />Number of vehicles the applicantproposes to use in the collection of recyclables `-� <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />� <br />��+�w,x�►*,r!* Glass* Cans/Plastic* <br />+ r� � o ,� <br />� <br />.��; t�.�, ��� ^. <br />O�ce paper/Boxboard* Corrugated Cardboard* Other(please specify) <br />�. �... �'r <br />*Required items for residential and multifamily haulers <br />I have been provided with a copy of the City of RosevilleCurbside Recycling Ordinance and understand that violation of any of the <br />provisions included in the ordinance may result in suspension or revocation of the license. <br />I have attached a certificate of liabili��� ir��ur� � cer��f ra ir�dicating 14'or7ver �'aar�peoaaiion �Y t one[ sh� fo� �' S f�$,�. <br />l(� -� �- � � � �- <br />Date AFpLi�t'e Sigrw[ure Title <br />
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