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O <br /> Request for Reprint of Oversized Documents <br /> or Building Plans and Blueprints <br /> L9kE5 0 <br /> Date of Request: �- <br /> Document Address: To � �/��i� /I CS' <br /> Name: r;Y-- -CY\ <br /> Address: 1(0( �J �_ a-�!'� Uc�� � T 30 <br /> City: State: vt-k M Zip: �c O <br /> Phone �7�� ^y ? 3 - 3S-o1U �(Sa " �I73 - ? �UC� <br /> (Work) (Home) <br /> Description of document(s) to be reprinted: �=�c� CPA Jr //YJagt S <br /> / 7x CU <br /> CHARGES: All charges must be paid at the time of the request, and are non-refiindable. <br /> Requests must be picked up at the City offices unless other arrangements have been made. The <br /> charges for reprints of oversized documents and building plans/blueprints are based on the <br /> following: <br /> Cost of Prints: SO <br /> Special Handling Fee: /off• 5—b <br /> Pickup/Delivery Fee -------$10.50 ---. <br /> Subtotal f,"5 57D <br /> 6.5% Tax (prints/handling/delivery): 3 0 /P0 <br /> Clerical Fee $ 5.00 <br /> TOTAL --� 0_ <br /> (signature) <br /> 2750 Kelley Parkway,P.O.Box 66,Crystal Bay,MN 55323 <br /> Phone: 952-249-4600/Fax: 952-249-4616/www.ci.orono.mn.us <br />