Laserfiche WebLink
Na�ne and address of each transfer station, disposal facility and composting facifity used for each ofthe following: <br />(attach additional pages if needed) <br />Garbagc <br />S"�'.5 s��4lc�� <br />Yard W�steBrush <br />Construc�ion/Demolition Debris <br />.��,� <br />Organics <br />Include a copy of the disclosure form used to inform customers ofthe disposal facilities used by the applicant. <br />Residential Customer Rates <br />Please include all relevant taxes and fees including s�rcharges. <br />These will be published and otherwise made available to residents. <br />Service <br />32 GaIIon Service* <br />64 Gallon Service* <br />96 Gallon Secvice* <br />Walk-up Service* <br />Additional Garbage"` <br />Yard Waste�` <br />*'These services are required to be offered in Roseville. <br />Cost <br />(per month} <br />(pet month) <br />(p� �nonth) <br />(p� month} <br />I have been provided with a copy of the City of Roseville Solid Waste Collection Ordinar�ce and understand that violation <br />of the provisions included in the ordinance may result in suspension ar revocation of the license. <br />I have attached a certificate of lia6ility insurance, a certificate indicating Worker Compensation coverage, the fee of <br />$125.00, and a copy of the disposal facility disclosure form. <br />�,�.��' ��'�"_ <br />Applicant's Signature <br />%%C�/�i D �U ' <br />Title ' �� <br />�I � ��� �� <br />Date <br />