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Name and address of each transfer station, disposal facility and composting facility used for each of the followiug: <br />(attach additional pages if needed) <br />Garbage <br />....—� <br />���������; � � <br />Yard WasteBrush <br />,J�� <br />`� ` <br />� <br />, <br />Construction/Demolition Debris <br />id�� � �Df�.� �� �� <br />���..�� �� �� <br />Organics <br />Include a copy of the disclosure form used to infornl customers of the disposal facilities used by the applicant. <br />Residential Customer Rates <br />Please include all relevaut taxes and fees including surcharges. <br />These will Ue published and otherwise made available to residents. <br />Seivice <br />32 Gallon Seivice* <br />64 Gallon Service* <br />96 Gallon Service* <br />Walk-up Service* <br />Additional Garbage* <br />Y�rd Waste* <br />Organics <br />*These services are required to Ue offered in Roseville. <br />Cost <br />�� �� <br />__ (per mouth) <br />� � (per month) <br />k� � � � (per month) <br />� (a i� <br />(per month) <br />— '1"�� <br />�( � <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 inchided in the ordinance may result in suspension or revocation of the i� ense. <br />i <br />I have attached a certificate of liability insurance, a certificate indicating Worker Coi en tion coverage, the fe <br />� 125.00, and a copy of the disposal facility discLosure form. <br />tv'��� <br />w�r' <br />'s Signature <br />�� � U�/ � � 1 <br />Title <br />��I-l��l� <br />Date <br />