06-13-1994 Council Packet - Laserfiche WebLink

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>* */,.ONO » >"6 6 /Bay» MN 553 23 /57 License Year Date Received Fee Paid Initials GARBAGE & REFOSE COLLECTOR* S LICENSE APPLICATION The undersigned wishes to operate the indicated business in the City of Orono and herewith makes application for a license to do so. Business/Pirm . Jh / ■- - -- - - - --- - Address -^ (Str^RIr (City] (State) Business Phone Number 3 - - - - - - - (Zip Code) Applicant's Name _ Address (Street) ' Phone Numlaer ? 3 «=,i_ _ __ " (City) _ _ _ _ _ _ _ (State) (Zip Code) Check One: _ _ _ _ Individual _ _ _ _ Partnership Number of Vehicles to be used in Orono /_- - - - - - -- Description of Vehicles (attached list if more): Loaded Loaded Year Mfcr. Gross W t. Rear Axle Wt. Size/Yards 1/ Corporation :* TT*V I •U a I I U*f U'MWfTl.* L t f w lim ^ * 'I wi t aw ' T ( * ““f • a a I V wvT -rvW'Jl License wWiinber/l • 11 w C i i ~ f ** » iVniVA V'y^-/ 7?-’■ .L;: /L'C . General area of City served r'Z'yt^, /t? ( Schedule of Collection charges/ dates A-fon _ _ _ _ _ _ _ __— Approximate number of customers in Orono /o _ _ _ _ _ _ _ _ _ _ _ ___ _ Location of dumping area _ _ In”o^ER for this APPLICATION TO BE COMPLETE, YOQ MUST ENCLOSE THE FOLLOWING: Surety bond in the amount of $1,000. Proof of insurance in the amount of $100,000-$300,000-$50,000, and 10-day cancellation clause. Annual fee is a S30.00 flat rate fee, plus $15/truck, and a $30.00 transfer fee (if applicaoie;. _ __ _ __ _ mm mm mm mm mm mm mm mm I am the owner and operator of the above business and I have paid all license fees and taxes required by law. The above information is correct. _ _ ___ _ _ _ _ _ _ _ _ Applicant / Date _ _ _ _ _ _ _ _ _ for city use ONLY: After review of application, staff recommends: Approval _ _ _ _ _ _ Denial _ _ _ _ _ _ Other (specify) Signature of City Official Date