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Narne and address of each transfer station, disposal facility and composting facility used for each of the following: <br />(attach additional pages if needad) <br />Garbsge Construction/Demolition Debris <br />s�N � ��.h�d �`�:se[Q�u,�� _ �eE at��Ghed ��se_)o��r� <br />Yard WasteBrush <br />� r� �� � c� s._ TeG�. v�.� � c? q. �. <br />-- 3 7 St� ��.� h�a ��or ia-�e_ !� � <br />V��h�►P�c� �i S <br />Organics <br />�J v'tro �C_ �� I-�tn• {C %r�s -�t"' S {�,"{`i � <br />�5�.7" ►'1�1� Y1 �°. � i 5' +� � <br />_ i <br />Include a copy of the disclosure form used to inform customers of tha disposal facilities used by the applicant. <br />Residentsal Customer Rates <br />Please include all ralevant taxes and fees inc[uding surcharges. <br />These will be published and otherwise made available to residents. <br />Service <br />32 Gallon Service'� <br />64 Gallan Service� <br />96 Gallon Ser�ice� <br />Walk-up Service* <br />Additional Garbage* <br />Yard Waste�' <br />Cost <br />�p �es`tiae,,,�f�a� <br />� iE.''1� �/ 1 G� YJ Y`f3 rJ �� c� �c� <br />I <br />(per month) <br />(per month) <br />t 1\ �OSL v i� IE (Per month) <br />� (per month) <br />� <br />*These services are required to be offered in Roseviile. <br />I have been provided with a copy ofthe City ofRosaville 5olid Waste Collection Ordinance and Lmderstand thaY violation <br />ofthe provisions included in tha ordinance may result in suspension or revacation ofthe license. <br />I have attached a certificate of iiability insurance, a certificate indicating Wor[cer Compansation coverage, the fee of <br />$125A0, and a copy of the disposal facility disclosure form. <br />'� � L87'�� <br />Applicazit's Signature <br />� I � � '% .��. �.����L <br />a ��� <br />Date <br />