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Change Order Form �Bonestroo <br /> File No: 000139-07020-0 <br /> Projed Name: T.H. 12 Sewer and Water Service Connedions <br /> Client: City of Orono <br /> Contrador: Burschville Construdion <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 /> Bormstroo:[CS.�[Charge Order Form-1 jtw�[VLM 021307� Page 1 of 2 <br />