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�1ame and address of each transfer station, disposal facility and composting facility us�d for each of the follo�ving: <br />(attach additiona( pages if needed) <br />Garbage Construction/Demolition Debris <br />_��_ r��c� �� � � �r_��-����(� <br />; <br />���c������ � ���������-�� <br />Yard �Vaste/Brush <br />Organics <br />(,��i_i�l t C. J�i'_c`.`�� Vi[�'0 c''\/ C7 �`����I\ I U 11 �lZ�'� �'�C�71S�'�I^ �'�cl`�rCiY� <br />�7 ��' �-���� s�i�`n��r i4v�. l�� <br />;�11 � I�t i � Ei�.�;'o % �`_s � , � , 1, �i �v �;,���Z�?�� �;� � `'i%' � �? , <br />Include a copy of tl�e disclosure fornl used to infornl customers of the disposal faciliries used by the applicant. <br />Residential Customer Rates <br />Please include all relevant taxes and fees including surcharves. <br />These will be published and othecwise n�ade available to residents. <br />Service <br />32 Gatlon Service�` <br />64 Gallou Service* <br />96 Gallon Servic� <br />i <br />Walk-up S�r'vice* <br />Addihional Garbage* <br />Yard Wastz* <br />Organics <br />�/�, I ,� <br />�f}�'�;�, .. tJ�'��t,4: ?Z�L�iL <br />-��'l `�. � ��� % � �r� � �L���� <br />*These services are required to be offered in Roseville. <br />Cost <br />(per m nth) <br />el" LI1011t11� <br />� (per month) <br />(per month) <br />I have been provided with a copy of the Ciry of Roseville Solid `Vaste Collection Ordinance and understand that violation <br />of the provisions included in the ordinance may result in suspension or revocation of the license. <br />I have attached a certificate of liability insurance, a certificate indicating �Vorker Compensation coverage, the fee of <br />S 125.00, ar.d a copy of the disposal facility disclosure forn1. <br />,, <br />? . 9 <br />� '�l ,7,� !i> � '� �'1� <br />Applicant'S Si�, ture � <br />�%��' �ifJ_� C'�''�� ( ��'�-'?/IC�!'�'cl�/L �' `.- <br />Title <br />J <br />ll'��U"l� <br />Date <br />