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city of Orono <br />Box <6 (2750 Kelley Parkway) <br />CrysUl Bay, MN S5323 <br />(952) 249-4600 <br />License Year "VXfl- - <br />Date Received ^/ / <br />Fee Paid l^Initials fJO <br />Garbage & Refuse Collector's License Application <br />The undersigned w’lshes to operate the indicated business in the City of Orono and herewith makes applications for a <br />license to do so. <br />Busincss/Fiim. <br />Address <br />(yf J <br />9^13 FlyiOtj C.ln^n Aar t=/4g <br />(Street) <br />Business Phone Number Q53L- QHI - <br />(City) <br />XtiC _________ <br />fefliBUl Mm <br />(State)(Zip code) <br />Applicant ’s Name_____Qfl N ____________ <br />Address . Si? Oft. UpvJ MnT <br />^(S(Street) <br />Phone Number qgA-TgH <br />(City)State) <br />/ <br />(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 />Y<ar Mfgr. Grosswt Rear Axle Wt. £i <br />— ------- -■ ^tjAChiO 5H<z^T <br />Size/Yards License Number <br />General area of City served C^iiy Li*Ai'jS ___________________ <br />Schedule of Collection charges/ dates \ft/£(ik iy ~ OfiyS <br />Approximate number of customers in Orono /S>00 <br />Location of dumping area CCxJsAy PiN£ <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 of5100,000 - S300.000 - $50,000 and 10-day cancellation clause <br />■ Annual fee is aSSMfi flat rate fee. plus SI5.00 per trucks and a S30.00 transfer fee (if applicable). <br />1 am the owner and operator of the above business and I have paid all license fees and taxes required bv law I have <br />verified that the above infotiharion is correct ^ <br />Ap^irdMt Sig Date <br />FOR CHt use ONLY: After review of application, staff recommends: <br />Approval i ____Denial ____Other (specify)Approval i ____: <br />Signature ofciiy OfTiciai <br />• I' -T