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City ofOrono <br />Bok 66 (2750 Kelley Parkway) <br />Crystal Bay, MN 55323 <br />(952) 249^600 <br />Lic.n..Y» ?CCtt-20.3 <br />Date Received <br />Fee Paid I70r Initials -pO <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/Firm <br />Address <br />ppj (rf Mogth Xf\c. <br />Fiyi»)o An~ £/i£KJ ftifliFiyi^jq C.lojiT^. £/fei^A;0ifc Mw ^^3^1 <br />(Street) (City) (Sute) (Zip code) <br />Business Phone Number Q53L* * 5I7H <br />Applicant's Name______Qfl N tJ i gi ^_____________ <br />Address ______a P f)g- iJgliJ <br />(Street) (City) ^ <br />Phone Number <br />State)(Zip code) <br />Check One:Individual Partnership /Corporation <br />Number of Vehicles to be used in Orono 7 <br />Description of Vehicles (attach list if more): <br />Year Mfer. Gross wt, Rear Axle Wt. Size/Yards <br />_ ___ fiik£hto 5//fccT <br />License Number <br />General area of City served Ci'fy /.iMt'f.S <br />Schedule of Collection charges/ dates W^^kly ~ OAyX V a A^ <br />Approximate number of customers in Orono /5>00 <br />Location of dumping area PiN^f^tJQ Ljl’Jef*!/ <br />IN ORDER FOR THIS APPLICATION TO BE PROCESSED, YOU MUST INCLOSE 1 HE FOLLOWING <br />■ Surety bond in the amount of S 1,000. <br />■ Proof of insurance in the amount of 5100,000 • 5300,000 • 550,000 and 10-day cancellation clause. <br />■ 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.xe$ required by law. I have <br />verified that the above infontiation is correct. <br />FOR CITY USE ONLY: After review of application, staff recommends: <br />AppMfant Si <br />Approval t ____v <br />iicnature oKity Official <br />Date <br />Denial Other (specify)