LICENSE APPLICATION AND REQUEST TO ENTER INTO AN AGREEMENT
WITH THE CITY OF DETROIT LAKES FOR SOLID WASTE COLLECTION
SERVICES
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A. General Information:

   1. Name of Business or Applicant ___________________________

   2. Address _________________________________________________

   3. City/State ______________________________ Zip ___________

   4. Contact Person _________________ Telephone # ____________

   5. Social Security # _______________(if sole proprietorship)

   6. Type of Business  [__] Sole Proprietorship
      [__] Corporation  [__] Partnership

   7. List names of all individuals with any ownership in the

      business: _______________________________________________

      _________________________________________________________

      _________________________________________________________

   8. List any "silent partners" associated with the business,
      include name, address, and a description of their
      interest:

      _________________________________________________________

      _________________________________________________________


B. Description of Equipment to be Used for Solid Waste
Collection - List Equipment, Make, Year, Size, Weight,
Condition, and Previous Years of Service:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

C. Proposed Pick-up dates:
   - For rubbish and garbage, recyclables, etc., attach a
     schedule of pick-up dates.

D. Financing Plan:
   - Attach a schedule of rates for all services to be
     provided.

E. Method of Solid Waste Hauling:
   1. List places where all types of solid waste will be
      hauled:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    2. Describe how solid waste is to be hauled:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    3. Address and legal description of principal site from
       which applicant will conduct business:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

F. Background Information:
   1. Describe applicant's experience inthe solid waste hauling
      business:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    2. List of date, name, and place, if any, where applicant
       has ever had a license revoked or rejected by municipal,
       state, or federal authority:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    3. List date and places, if any, where applicant has been
       convicted for the violation of any law of the United
       States or of any state, or for the violation of any
       municipal ordinance; and

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    4. Provide the names and address of at least three business
       references with brief statement of the nature and extent
       of the business relations:

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________