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Dec-06^� DEC Q6 '81 . ?Z26PM ORONO_ +9522494616 T-314 P.002/OOZ P�2i2 <br /> est t404. <br /> Amount: $ � , . 73— <br /> initials: <br /> in.itials: -, �' <br /> (t77--)--\e-0 /c 2 c /L <br /> /�Ctyf iL <br /> REQUEST FOR REPRINTOF OVERSIZED DOCUMENTS / <br /> OR BUILDING PLANS AND ,BLUEPRINTS S.J2L: X� <br /> Date of Request: l 2 ! to J D <br /> Name: �� Y` (.418,c'z._ <br /> ICI6),4n °`.� l sk�- <br /> Address: CldI AGn--1 ye-11W- <br /> City: <br /> W-City: /12,in/,An phi i State: ,til/ Zip: �s�S ,0 <br /> Phone: (Work) ‘ii,/33,P (Home) <br /> • Description of document(s) to be reprinted: <br /> bNt. LU i C C1 hu. <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 /> Build] dans 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 /> Signature <br /> xmpps\WpwrNsokwpoOcs\DE cunt roRmskREPRrxr.FRM • <br />