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� <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 />Fee Due: $125.00 Year �5 (License will be for January 1 to December 31.) <br />Business Name �rU{{t �Q,Q,S ��t�j�? a 1� k-+�3� <br />Business Address ��� r_ � � �� � �e.� ��� � ;��?� <br />Contact Person �� ���,tar� r.3 Business Phone ? G 3" a t o',��P 1 <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 collectionof recyclables � <br />Name and address of companies or materials recovery facility where recyclables will be delivered: <br />Newsprint* Glass * Cans/Plastic* <br />�� � � - St PiAJ� �' <br />. -. .��* � <br />i/ <br />�_�r���?�� <br />�� <br />O�ce paper/Boxboard* Corrugated Cardboard* Other(pfease specify) <br />� _ . ��+.�.«.t <br />r <br />.- .�� . ±?��.k. - �� <br />*Required items for residential and multifamily haulers <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 />provisions included in the ordinance may result in suspension or revocation of the license. <br />I have attached a certificate of liability insurance, a certificateindicating Warker Compensationcoverage, and the fee of $125,00. <br />�� � � 'f ����� <br />a1,� icant's Si�mrc Title <br />