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CityofOrono <br />Boi 66 (2750 KeUey Parkway) <br />Crystal Bay, MN 55323 <br />(952) 249-4600 <br />License Year______ <br />Date Received_____ <br />Fee Paid.___Initials <br />Garbage & Refuse Collector's License Application <br />Tbe undenigned 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 RanJv/*S 4r> i'.on ZT/JC • <br />Address US Aitvj/ /x g/r m rj <br />(Street) ' (City) <br />Business Phone Number {7Li} *17Ji - 3 3 3 S <br />(State)(Zip code) <br />Applicant's Name Sq <br />Address <br />Phone Number <br />Check One: <br />(Street) <br />P <br />(City)(State) <br />Individual Partnership <br />(Zip code) <br />Corporation <br />Number of Vehicles to be used in Orono /_____ <br />Description of Vehicles (attach list if more): <br />Year Mfgr. Gross wt. Rear Axle Wt.Size/Yards License Number <br />% <br />uenerai area oi L^iiy servca <br />Schedule of Collection charges/ dates 3 0 03^1?. <br />rApproximate number of customers in Oron <br />Location of dumping area <br />IN ORDER FOR THIS APPLICATION TO BE PROCESSED, YOU MUST ENCLOSE THE FOLLOWING: <br />■ Surety bond in the amount of S1 ,000. <br />■ Proof of insurance in the amount ofSIOO.OOO - S300.000 - S50.000 and 10-day cancellation clause. <br />■ Annual fee is aSiQ.M flat rate fee, plus S15.00 per truck, and a sa0t«l5Nirnffi»^^pf <ipp|ir-Mf|__ <br />I am the owner and operator of the above business and t have paid all license fees and taxes required by law. I have <br />verified thanheabove information is correct. <br />Applicant Signature Date <br />FORpifY USE ONLY: After review of application, suff recommends: <br />' Approval Denial Other rtn^riA/V <br />SignSure erCily Oftlcial ' <br />Denial <br /><30 <br />Other (specify)