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CITY OF O66 DatenPC Yca Z_ <br />P.O. Box 06 Date Rec ivrd <br />Crystal hay, MN 55323 Fce Paid �� I,it als ns%I <br />473-7357 /'yam <br />GARBAGE L REFUSE COLLECTOR'S LICENSE APP. ATTON <br />The undersigned wishes to operate the indicated business in the City of Orono and <br />herewith 'hakes application ,for pa license to do so. <br />Busineus/Firs /� w...�.!. .di.w. iw.. J <br />y <br />Business Phone Number <br />Applican <br />Address <br />,phone Number V79- IY47 ._ <br />Check One: Individual Partnership _X Corporation <br />Number of vehicles to be used in Orono <br />Description of Vehicles (attached list if more): <br />Loaded <br />Loaded <br />Year <br />Nfgr. <br />Gross Wt. <br />Rear Axle Wt. <br />size/Yards License Nunber <br />$ /O'/ <br />A179 <br />,39ao <br />4MOVV <br />— R V9 7732/ <br />. <br />&A?O <br />%977 <br />390so_ <br />e?aoso <br />_1 1 11,e_ 73.12 <br />General area of City served uy[ --// <br />Schedule ok ^ollection charges/ dates /Q �ePA, /A <br />Approximate number of customers jinn Orono <br />o 30"m <br />Location of dumping area , -__ <br />........... ________________ _.______FOLLOW___ <br />IN ORDER FOR TEIS APPLI TION TO ijE-COMPLETE: YOU MUST ENCLOSE THE POLLfri'ING: <br />O <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 <br />$30.00 flat rate fee, plus $15/truck, and a $30.00 transfer fee (if applicable). <br />_________________________________________________________.._________________ <br />I am the owner a o e_ralos')of the above business and I have paid feef <br />and taxes r u:r y law. The above information is correct. <br />_ A/- <br />App :cant Data <br />__________________________________________________________________________ <br />FOR CITY USE ONLY: After review of application, staff recommends: <br />Ap oval De.iial Other (specify) <br />4 #i -Q(e <br />. :qna tS ure of Official Date <br />