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Amount: $ �/ • � � <br /> Initials: .�� <br /> REQUEST FOR REPRINT OF OVERSIZ�D DOCUMENTS <br /> OR BUIL,DING PLANS AND BLUEPRINTS <br /> Date of Request: �/�-�/�'j <br /> � <br /> Name: �. ���;- �s ��,,�,,,�,�, <br /> / �� ,� � <br /> Address: 7 7�' �c lC<<,, �� �� � <br /> City: �� � � ���' State: �'1✓ Zip: ����� <br /> Phone: (Work) (Home) �� 7�- 7�7��5 <br /> � <br /> Description of document(s) to be reprinted: �� ��.s.r ���� S <br /> CI-�ARGES: (the follo��ina charges are subject to rate changes) <br /> li�"CT`ii'LC;il �VCLiiilcTl�t:i f,Cit; *v�i',;.'�:�Flm �� C) � ��� -!- ��, .S D/�_Jr"� ri 1� <br /> The charge for such reprints is the cost of copying service, :V�esscnger service and a minimum <br /> clerical fee of $5.00. <br /> Buildina Plans and Blueprints <br /> The charge for such reprints is the cost of cop��ing 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 ofEces unless other arrangements have been made. If prints are <br /> delivered and picked up by a courier service, the charge for such servi�e is to be paid by <br /> requestor. <br /> ,.. <br /> C /�_ �� _ _ _ <br /> ( / <br /> __ _. �� ' <br /> , <br /> T�� <br /> Signature <br />