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2004_1108_Packet
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2004_1108_Packet
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� r � <br />- T �i � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55ll3 <br />(651) 490-2212 <br />Recycling Hauler License Application <br />���e�: �i��.� v� ���— — <br />BusinessName _F,�,��,�,{ (`'� � _ <br />Business Address <br />will be for January 1 to December 31.) <br />C 4 . 4 <br />� <br />� I �, 4-{ <br />r �i�l �+ �k--_ � , �x � �L 7� � 11 i �� � � � � � <br />Contact Person (�}`� k��� � , � _ „ Business Phone ��� � �.� - ��,� <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 ��Iultifamily 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 recyclableswill be delivered: <br />� ?5+e ���rxrt' � Gf�ss� J5 - � �' s�'P�akr}e' <br />� y . . � <br />r�,���] � , ii��,� �;�� ��'�1'��. . ..�. � <br />�� _ �--� — -- ,..ti <br />o�+c���r�o.r�o�• � �'o,rra�g�red �f• <br />� ' �� �' � _ <br />*Required items for residential and multifamilyhaulers <br />Or�ier���u� r�,�c't�� <br />I have been provided with a copy of the City of Roseville Curbside Recycling Ordinance and understand that violation of any of the <br />prcivisians iiscluded ���� �he urdin�nc.e rn�y resu�t i p su�pensi+,m or 4•{,caiian � h� Li�eria�. � <br />;�,��� �.� �,� ���ti�� �� �� Ts-�� ��i �� ����'�� � <br />I I�we atiachcd a rti ��a1e of liabiJi ineurar�c�� � Ce�ti�ir�he ind� ting 1�14rk�r ��P��� C+a �o� �nd lkie f� �f 5��_f�. <br />- � - <br />i �. <br />17a[� ' ,�PPlieari�'S 5ig���urc T1�9r <br />
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