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• • •• <br />0 / <br />CityofOroDO <br />Box 66 (2750 Kelley Paikway) <br />Ciystal Bay, MN 55323 <br />(952) 249^600 <br />License Year . <br />Date Received' <br />Fee Paid Initials ID <br />Garbage & Refuse Collector's License Application <br />tlie undersigned wishes to operate the indicated business in the City of Orono acd herewith makes applications for a <br />license to do so. <br />Business/Finn. <br />Address <br />S/)aJi r/t T//?/j yAJd. . <br />(Street) (City) <br />Business Phone Number <br />Applicant's Name_______d.^/^tG- <br />Address <br />(State)(Zip code) <br />Phone Number <br />(Street) (City) (State) (Zip code) <br />Check One:Individual Partnership ^Corporation <br />Number of Vehicles to be used in Orono <br />Description of Vehicles (attach list if more): <br />Year Mfer. Gross wt Rear Axle Wt. <br />A.‘6~ B7rrr > /rn <br />Size/Yards <br />y>s <br />License Number <br />y/i-A-' o ni:^^ <br />General area of City served <br />Schedule of Collection charges/ dates <br />Approximate number of customers in Orono <br />Location of dumping area <br />IN ORDER FOR THIS APPLICATION TO BE PROCESSED, YOU MUST INCLOSE THE FOLLOWING: <br />■ Surety bond in the amount of $ 1,000. <br />■ Proof of insurance in the amount of $100,000 • $300,000 • $30,000 and 10-day cancellation clause. <br />■ Annual fee is a 550.00 flat rate fee, plus SI5.00 per truck, and a 530.00 transfer fee (if applicable). <br />I am the owner and operator of the above business and I have paid all license fees and ta.xes required by law. I have <br />verifled that the above information is correct. <br />'•■gjiSturc yApplicant Sigjfeture <br />/ <br />Date <br />FOR^flY USE ONLY: After review of application, suff recommends: <br />__2_Aprrova|^ ____Denial ____Other (specify) <br />Signt^^Cify^^^ <br />A <br />I