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' # • . R <br /> �O -I <br /> O � O <br /> � �-�i�,�. � ,, Request for Reprint of Oversized Documents <br /> � �� <br /> � �� '�' `� �,��' or Building Plans and Blueprints <br /> �`�kEs8o4'� <br /> Date of Request: %-Z�-D y <br /> Document Address: 280 �o L(��Q,� �GZ a� <br /> Name: �`�� �n � <br /> Address: 2�� � u�'`O�-Q'` � <br /> City: � Z�cc State: � Zip: 5539/ <br /> ��' S�z°� <br /> Phone: Q52 "�7 3 - L��►'�9 O <br /> (Work) (Home) <br /> Description of document(s) to be reprinted: ��Q.p� v� ��-u-��"'� /���� <br /> CHARGES: All char�es must be paid at the time of the request, and are non-refundable. <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 oii the <br /> following: <br /> Cost of Prints: `�XB= 3Z.vo <br /> Special Handling Fee: /a. so <br /> Pickup/Delivery Fee _______$10.50 ___. <br /> Subtotal ,SS a o <br /> 6.5% Tax (prints/handling/delivery): 3. S6 <br /> Clerical Fee $ 5.00 <br /> TOTAL (03. Sg �° G'�C' 70� y��'/os� <br /> (si ture) <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 />