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Change Order Form '4 Bonestroo <br /> File No: 000139-07020-0 <br /> Project Name: T.H. 12 Sewer and Water Service Connections <br /> Client: City of Orono <br /> Contractor: Burschville Construction <br /> Prepared By: Jared Ward Date Needed: 10/13/08 <br /> Change Order No: 1 Draft or Final: <br /> If applicable, include: MSA No., MSA(Non)Participating;MSA Item No's.,Project No.,Time Extension, FmHA,MPCA, <br /> No.of Additional Copies(5+) . Other <br /> Description of Work: <br /> Items 1 &2:Additional GV and watermain needed to isolate Sugar Woods Development <br /> Item 3: Additional area disturbed to install water main. <br /> Item 4: Installation of tee on existing line. As-built called out wrong tee size. <br /> Items 5&6: Additional fittings needed for watermain service connection at TH 12. <br /> Item 7: Nut extension needed in order to operate GV. <br /> Borrestroo:IC.SJICharge Order Form-1 jtwl{VLM 021307] Page 1 of 2 <br />