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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 <br />` l_ <br />�� � � �',J � c: . i �� i�� ��2� �=t''c_ ;l f` � <br />�� i � ��l l�(���� (_ `�^ �- <br />�� -M�� ��� i i�1 �L� �� I C� � <br />Yard Waste/Brush <br />y� :. <br />C��'�;��1�� �C' ��t:('1�������� ���,f��� -�-,��;- <br />���%`.�% 1 v�i,�'��n� %� � � <br />i��'1���=� ��,1 � ; '_�-� /�,-� <br />Construction/Demolition Debris <br />lTC�"�.t�i����l���Jl i�', :�/l ���'%��� <br />� _ <br />-��� �'i n'�c' ���� <br />��i c�� :, � �"��.��,' ��� �C� 3 <br />Organics <br />Include a copy of the disclosure form used to inform customers of the disposal facilities used by the applicant. <br />Residential Customer Rates <br />Please include all relevant taxes and fees including surcharges. <br />These will be published and otherwise made available to residents. <br />Se�vice <br />32 Gallon Service* <br />64 Gallon Service* <br />96 Gallon Service* <br />Walk-up Service* <br />Additional Garbage* <br />Yard Waste* <br />Organics <br />*These services are required to be offered in Roseville. <br />Cost <br />� ,� ,�j � (per month) <br />� � �/ <br />'� (per month) <br />.��� Cl `7 (per month) <br />/ �-� (per month) <br />�/.S�J -�c <br />� <br />� ��� -���_�, <br />It� ,/+- � <br />I have been provided with a copy of the City of Roseville Solid Waste Collection Ordinance 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 liability insurance, a certificate indicating Worker Compensation coverage, the fee of <br />$125.00, and a copy ofthe disposal facility disclosure form. <br />�__! <br />� � , `�" .�-_ . <br />j ` ,L�', <br />�--� � � Applicaut's Signature <br />1 <br />��'���� �C;��'�/;���.��-;:��`,'/ <br />Title <br />�J����/�� <br />Date <br />