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If licensee t~'a ~oratlon state here: ..' <br /> <br />.~ Co.rate .~,~,__.Waste Management of Minnesota~ Inc. 14730 Sunfish.: Lake Boulevard <br />b) Co~rat~ ~ddre~ <br /> <br />individual; . partnership <br /> <br />Anoka, 'Minnesota <br /> <br />c) corporate erss~d, nt: William }tulligan <br /> <br />d) Mtate o! ]ncol]~oratlonl Minnesota <br /> <br />the licensee im a partnership state here the name and address of the part~er~, <br /> <br />N/A <br /> <br />Indicate here an alte~nat~ sddress'{address other than establishment), for the service o~ offioial notice~l <br />a) ,~: Waste Management of Minnesota, Inc. : '" <br />~) xaare~: P. O. Box 67, Anoka, Minnesota <br /> <br />Regardle~ of t~ of licensee {~rat~on, ind~vtd~ proprietor~hip, ~rtner~hip, etc) ~tate here ~.fo~tion c~ncernlng <br />the in~v~dual locally res~nsible for the ~nage~nt of this establish~nt~ <br /> <br />~) ~ Terry C. Miller <br /> <br />b) .e~nc. a~dr~ss: .7460 Mississippi Dr.', Champlin, MN 55360 <br /> <br />c) Re~t6ence Telephone, (612) 472-0878 <br /> <br />Have you ever h~d a license denied (Yes No X ), suspended (Yes No ), or revoked (Yes No )? If yea: <br />a) ~%at typ~ Of license: N/A <br /> <br />bi ~%ere was it denied, suspended, or revoked: lf/~ <br /> <br />c) For what reason wa.~ the license denied. ~uspended~ or revoked? ~/A <br /> ~ . - N/A - new facility <br />Have there b~en any changes to the establishment during t_he past year? Ye~ NO If yes, describe <br /> <br /> <br />