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No.247—AppllenUou for Munlelpol Lleensel Genorol Form. (Revised 1926.) MN.LMDAVle CO..MINN[APOLIC <br /> btate of Alinne0ta, RENEWAL DATE: March 15, 1996 <br /> .r ss. Garbage Haulers License <br /> County of....Hennepin..Ramsey <br /> •• Certificate of Insurance <br /> TOTHE.............................Citi!...Council........................................OF THE.................City............................................................................ <br /> OT.............St............A....n......thony...............................................................................................................................IN S✓IID COUNTY' .4ND ST.1TE: <br /> The undersigned hereby applies for a license to carry on the business of.....hauling garbage <br /> ............................................................ <br /> refuse, recyclables and yard wastaet at various locations <br /> ....................................................................................................................................................... <br /> in the...................City....................................of.................S.t......Antho <br /> . ny.......................................in said county and state for the <br /> .... ................... <br /> One Year ......,from the date hereof, subject to the laws o .Minnesota and the <br /> term of f f l f <br /> ordinances of said...........City..................................................; and herewith tenders $........*................................as the license <br /> feetherefore.............................................................................................................................................................................................................................. <br /> ............................................................................................................................................................................................................................................................. <br /> A - Residential Recyclables and Non-recyclables $100.00 <br /> .................................................................. ...... .................................................. <br /> B - Commercial/Multipe Non-recyclables $100.00 <br /> ............................................................................................................................................................................................................................................................. <br /> C - Recyclables Only $100.00.................................... <br /> ......................................................................................................................................................................................................................... <br /> ............................................................................................................................................................................................................................................................. <br /> COMPANY NAME: <br /> ............................................................................................................................................................................................................................................................. <br /> ADDRESS: <br /> ............................................................................................................................ <br /> ................................................................................................................................. <br /> PHONE NUMBER: ....................................................................................................... <br /> .................................................................................................................................... <br /> SIGNATURE: <br /> ............................................................................................................................................................................................................................................................. <br /> MINNESOTA TAX ID #: ....... <br /> ...................................................................................................................................................................................................................................................... <br /> ............................................................................................................................................................................................................................................................. <br /> Dated..............................................................................19............. .............................................................................................................................. <br />