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CITY OF ORONO -fI' License Year <br />P:O. Box 66 -1 Date Received <br />'- - $ <br />Crystal Bay, MN 55323. MAY 919M Fee Paid oe Initials 7/ - <br />473-7357 ((1_1- FP.CU( F /7/9i <br />GARBAGE it UcESCOLIECTOR'S LICENSE APPLICATION <br />The undersigned wishes to operate the indicated business in the City of Orono and <br />herewith makes application for a license to do so. <br />Business/Firm <br />Address, ,?&, , <br />Business Phone Number d179-,2353 <br />Applicai <br />Address <br />Phone N <br />Check One: <br />Individual <br />Partnership <br />Corporation <br />Number of Vehicles to be used in Orono <br />/ <br />Description of <br />Vehicles (attached list <br />if more): <br />Loaded Loaded <br />Year Mfgr. <br />Gross Wt. Rear Axle Wt. <br />Size/Yards <br />License Number <br />General area of City served <br />Schedule of Collection charges/ dates Nat. <br />Approximate number of customers in Orono <br />Location of dumping area !C-A, <br />__________________________________________________________________________ <br />IN ORDER FOR THIS APPLICATION TO BE COMPLETE, YOU MUST ENCLOSE THE FOLLOWING: <br />Surety bond in the amount of $1,000. Proof of insurance in the amount of <br />$100,000-$300,000-$50,000, and 10-day cancellation clause. Annual fee is a <br />$30.00 flat rate fee, plus $15/truck, and a $30.00 transfer fee (if applicable). <br />__________________________________________________________________________ <br />I am the owner and operator of the above business and I have paid all license fees <br />and xes requir�a by law. The above information is correct. <br />7 <br />V <br />App/ ca / ----_ Date <br />-------------- /1____ _-_______-_ _-________-____________-_-___ <br />FOR CITY USE ldNLY:. After review of application, staff recommends: <br />[. 'Approval Denial Other (specify) <br />S�ignn!ure of City 0191cial Date <br />