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Amount: $ 3 I. 7 7 <br /> Initials: <br /> REQUEST FOR REPRINT OF OVERSIZED DOCUMENTS <br /> OR BUILDING PLANS AND BLUEPRINTS <br /> Date of Request: O L f / z"cc <br /> Name: CJD/ S - Z <br /> Address: - • 0-- ' u,,)r, ,50-6) <br /> City: 4_ /CsZ State: I-1 Zip: <br /> Phone: (Work) (Home) L 73 `-/C) <br /> Description of document(s) to be reprinted: ho a 0-)-• <br /> CHARGES: (the following charges are subject to rate changes) <br /> Oversized Documents from Microfilm <br /> The charge for such reprints is the cost of copying service, Messenger service and a minimum <br /> clerical fee of $5.00. <br /> Building Plans and Blueprints <br /> The charge for such reprints is the cost of copying service, Messenger service and a minimum <br /> clerical fee of $5.00. <br /> All charges must be paid at the time of the request, and are non-refundable. Requests must <br /> be picked up at the City offices unless other arrangements have been made. If prints are <br /> delivered and picked up by a courier service, the charge for such service is to be paid by <br /> requestor. <br /> _ 4 <br /> Signature \ <br />