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City ofOrono <br />Bos <6 (2750 Kelley Parkway) <br />Crystal Bay, MN 55323 <br />(952) 249-4500 <br />License Year ZOO^ ' 2C>o^ <br />Date Received" *•*/ 34- /o 3 <br />Fee PaidjjoU Initials ^ <br />Garbage & Refuse Collector's License Application <br />The undersigned wishes to operate the indicated business in the City of Orono and herewith makes applications for a <br />license to do so. <br />Business/Finn B1a«e«wialr S. Snn Tiv» Bnllnff Steryirw ______ <br />Address no*, amnyflwid nd M Mound ______W <br />(Street) (City) (State) <br />55364 <br />Business Phone Number (952)472-3398 <br />(Zip code) <br />Appi-canfsName Frarik n m;>rfcnariair <br />Address 1155 ftirtmrrioiA 'IM M <br />(Strci <br />SS3M <br />(Sheet) <br />Phone Number (952)472-2977 <br />(Citj>)(State)(Zip code) <br />Check One:Individual Partrership Corporation <br />Number ofVehicles to be used in Orono 4 Rollof f Trucks <br />Description ofVehicles (attach list if more): <br />Year Mfer. Gross wt Rear Axle Wt. Size/Yards <br />19Z Fri»4g*ifr-Hn«»-g 36,380 - a »iv« 8-12-20-30-50706 <br />•JO FmiahLliner 2Q«24D 8 ttan B-12-t20YDS <br />•jaa Inkecoatianal 2W,aan a «Pnn 8-I2-20-3O-50YES <br />*99 International 28,880 8 llcin 8-12-20-30-50yD6 <br />General area of City served all of Orono area_________________________ <br />License Number <br />YM06236 <br />YRF6641 <br />YMB139 <br />YMSISIS (SPARE m <br />NDIE: (%ace tnidr used only when break douns) <br />Schedule of Collection charges/ dates _____________ _________________________ <br />jam- ap ply <br />Appro.ximate number of customers in Orono ifcit- »|yi y <br />Location of dumping area ii»»m Plant In Brooklyn l^rlc,W <br />IN ORDER FOR THIS APPLICATION TO BE PROCESSED, YOU MUST INCLOSE THE FOLLOWING: <br />■ Surety bond in the amount of S1,000. <br />■ Proof of insurance in the amount of $100,000 • $300,000 • $50,000 and lO-day cancellation clause, <br />a Annual fee is a S50.00 flat rate fee, plus 515.00 per truck, and a S30.00 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 />verified that the above information is correct. <br />licant Signature <br />ITY USE ONLY: After review of application, staff recommends: <br />Approval ^ ____Denial ____O^er (specify) <br />haV-Sigmtur^y City Officia:ia^/ (K <br />IL