Laserfiche WebLink
City of Falcon Heights <br />AU G 10 '005 <br />LICENSE APPLICATION <br />TREE TRINIlVIING/TREATING AND REMOVING TREES <br />TO: City of Falcon Heights Fe <br />e. $30.00 <br />2077 W. Larpenteur Ave. Receipt #: 0~3~ ~~ <br />Falcon Heights, MN SS113 Date: ~ _ (~~ ~ <br />6S 1-644-SOSO Expires: 12/31/OS <br />Firm Name: ~'r <br />Business Address: <br />s'~ <br />Name of Owner: <br />Home Address: <br />~~~) <br />City State <br />City State <br />Zip <br />Telephone: Business ~~~ - ~ ~ _ ~ ~ 3 ~ Residence: <br />For which of the following are you applying? <br />~r ~ Trimm;ng ~ Removing ____~_ Treating <br />List your experience, naming municipalities in which you have done business: <br />e yvr ~ 'firfhw~~,~, ti tw u. <br />~_ <br />r <br />Zip <br />3. <br /> <br />C ~ <br />ITEMS REQUIIZED FOR LICENSURE: <br />• Insurance minimum of $300,000, $500,000, $100,000 <br />(The City of Falcon Heights should be named as additional insured) <br />• State of Minnesota Tax ID form <br />• State of Minnesota Worker's Compensation Form <br />• Proof of insurance must be furnished with application and must indicate 10 days notice before <br />cancellation. <br /> <br />`G ~ <br />• <br />I swear that the above statements are true to the best of my knowledge <br />and belief. <br />~~.--.rte • <br />igna <br />