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CITY OF ORONO License Year <br />P.O. Box 66 Date Received.�d.gY <br />Crystal Bay, MN 55723 Fee Paid y5,0 U Initiaisls , <br />473-7357 Teeup f <br />GARBAGE a REFUSE COLLECTOR'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 W 3 rext Kd ill vi rtf rIe AI <br />Address f?G &&e r1-/ Al qy gjY4E 6t/i �' 45�91 <br />(Street (City) (State) (Zip Code) <br />Business Phone Number � -/�779 <br />Applicant's Name )SJffA' R0C-6 <br />Address 3/dG ISLBNo V,Gw 2R <br />Phone Number <br />Check One: ✓ Individual Partnership Corporation <br />Number of Vehicles to be used in Orono <br />Description of <br />Vehicles <br />(attached list if <br />more): <br />Loaded <br />Loaded <br />Year .. 4r. <br />Gross wt. <br />Rear Axle Wt. <br />size/Yards <br />License Number <br />Z Nt <br />a?,V&e <br />1e,6e0 <br />rY <br />iV-'7yaSY <br />General area of City serve:' A'N ✓/IRa6 i drd68 <br />Schedule of Collection charges/ dates J'.% Me. <br />Approximate number of customers in Orono <br />Location of dumping area C#Al AKA _ <br />-------------------------------------------------------------------------- <br />IN ORDER FOR THIS APPLICATION TO BE COMPLETE, YOU MUST ENCLOSE THE FOLLOWING: <br />Surety bond in the amount of $l,DOO. 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 �^tya7xxpa required by law. The above information is correct. <br />(20k �C�ti��� 4114-AJ/ <br />AppYicantu Date <br />-------------------------------------------------------------------------- <br />FOR CITY USC ONLYs After review of application, staff recommends: <br />_ — Approval Denial Other (specify) <br />Signature of CITY Official <br />