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�01�0 Request for Reprints of Oversized <br /> Documents, Building Plans and Blueprints <br /> y 1 <br /> � G <br /> lgkES H G�� <br /> Date of Request: - ' <br /> Document Address: �� or (-) � <br /> Name: `C�')c�l N led i� )a lJ <br /> Address: <br /> City: /0 f) State: Zip: 7 <br /> Phone: J20L . (D/ ;?- - .3 ZS G/D3 <br /> (Work) (Home or Cell) <br /> Description of document(s) to be reprinted: �� �� L fel a 1 S <br /> CHARGES: All charges 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. <br /> The charges for reprints of oversized documents and building plans/blueprints are based on <br /> the following: <br /> Cost of V Prints / <br /> Additional Prints @ $ ea. _ <br /> Cost to Scan $ 5.00 ea. <br /> Pickup/Delivery Fee 17.50 <br /> Set-up Charge 20.00 <br /> Energy Charge 2.39 <br /> Subtotal '2 , y <br /> 7% Tax s -7-? <br /> Clerical Fee 5.00 <br /> TOTAL <br /> ( ignature) <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 />