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�o� <br /> o ,� o <br /> ,� '��� � ,, Request for Reprint of Oversized Documents <br /> � � ::���:,F ti <br /> � �� or Building Plans and Blueprints <br /> �9kESH��'� <br /> Date of Request: ��� � / <br /> Document Address: �.� 5 � I��CUG J���,f�"C L <br /> Name: /—���C2'`l,? �J� G{C G�.S�S�G C'/' <br /> Address: /..�5� � �'���Cj /��/�CL= <br /> , <br /> City: �-l��'�' �' State: ��1�� Zi � ���� <br /> ' p: <br /> Phon�' / z �� � .� ��J� � S�-'l d� 1� <br /> (Work) (Home or Cell) <br /> Description of document(s) to be reprinted: �.��s��C� ��r'r%�'Gv%l/cJ <br /> CHARGES: All char�es must be paid at the time of the reguest, and are non-refundable. <br /> Requests must be picked up at the City o�ffices 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 lst Prints _.,�� @ $ � �v�- ea. _. i , J �-�' <br /> Additional Prints @ $ ea. _ <br /> Cost to Scan �� @ $ 5.00 ea. =a ,�C? � ��C:� <br /> Special Handling Fee /:.�r � J�� <br /> Pickup/Delivery Fee 17.00 <br /> Set-up Charge 20.00 <br /> Energy Charge 2.29 <br /> Subtotal r�-.-�, �� � <br /> 6.5% Tax <br /> Clerical Fee ,�S-0.Q�_ <br /> TOTAL ( ..-=�_+=C,__;� _� <br /> �.-�__� �L `' � �� <br /> � <br /> �'%'i�l�'1�' r���"�-�`,,�''/� �- <br /> (signature) <br /> 2750 Kelley Parkway,P.O. Box 66,Crystal F3ay, MN�5323 <br /> Phone: 952-249-4fi00/Fax: 9�2-249-4616/ww�.ci.orono.mn.us <br />