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Garbage Hauler or Recycling License Application

  1. If application is made on behalf of a partnership, corporation or LLC, please furnish the following:
  2. Truck Information
  3. All trucks to be licensed must be listed below.
  4. Documentation should include the same information as the above entries.
  5. Type*
  6. Do you provide recycling service?*
  7. Fees
  8. First Vehicle License Fee
    Base Fee
  9. Price
  10. Additional Vehicles
    Per Vehicle
  11. Price
  12. Enter number of additional vehicles to be licensed.
  13. ($1,000,000/$1,000,000/$1,000,000)
  14. Are You a New Hauler to Edina?*
  15. I agree to send the Continuing Bond Form to the City. *
  16. Please do not provide the name of the insurance agent.
  17. I am not required to have workers' compensation liability coverage because:
  18. I certify that I have provided proof of coverage or I am not required to have workers' compensation liability coverage.*
  19. THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. We are requesting this data to determine your eligibility for a license from the City of Edina. Providing the data may disclose information that could cause your application to be denied. You are not legally required to provide the data, however, refusing to supply the data may cause your license to not be processed. Under M.S. 270.72, the City of Edina is required to provide the Minnesota Department of Revenue your MN Tax ID Number and Social Security Number. This information may be used to deny the issuance, renewal or transfer of your license if you owe the Minnesota Department of Revenue delinquent taxes, penalties or interest. The Department of Revenue may supply information with the Internal Revenue Service. In addition, this data can be shared by Edina City Staff, the State of Minnesota Driver License Section, Hennepin County Auditor, Bureau of Criminal Apprehension, Hennepin County Warrant Office and Ramsey County Warrant Office. By agreeing below, you indicate that you understand these rights.*
  20. Leave This Blank: