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Name and address of each transfer station, disposal facility and composting facility used for each of the following: <br />{attach additional pages if needed) <br />Garbage Construction/Demolition Debris <br />� f�l�/ �] '` �'fl (a.�P �� <br />_�� � <br />Yard WasteBrush <br />Organics <br />_ Si�- ��� ��.�y� �� -��1� <br />Include a copy of the disclosure farm used to inform cuskomars of the disposal facilities used by the applicant. <br />Residential Castamer Rates <br />Please include all relevant taxes and fees including surcharges. <br />These will be published and otherwise made available ta residents. <br />5ervice <br />�"a 3� Gallon Service* <br />�Cs� Gallon Service* <br />a�AS GalIon Service* <br />Walk-up 5ervice* <br />Additional Garbage* <br />Yard Waste* <br />#These services are rec�uired to be offered in Roseville. <br />Cost <br />�$`L � j�i�C � �sc. <br />' {per month) <br />��"4� ��� per mon�) <br />�, iR��'�Ai(p� � ontk►) <br />• �9 V (per mon#h) <br />Z �U � �A'i�lfi��1%L � <br />� �.�� �' V'b� <br />'��V � �� �f�� �� <br />I have been provided w�th a copy of the City of Roseville Solid Waste Collection Ordinance and understand that violation <br />of the provisions included in the ordinance �nay result in suspension ar revocatiaR of the licensa. <br />I have attached a certificate of liability insurance, a certi�icate indicating Worker Compensation coverage, the fee of <br />$125.60, and a copy of the disposal facility ciiscfosure form. <br />� ��� <br />Applicant's Signature <br />�va <br />Title <br />(a' � �'ii� <br />Date <br />