HomeMy WebLinkAboutInformation requests ORONO ADMINISTRATNE OFFS�S
=NFORISATION DISCLOSURE �Q�ST
�iINNESaTA C� DATp, PRACTICES ACT
REQUESTER NO�E:
A_ Reques� Frequency - Private Data on individuals. After the
have been supplied the data and �fforesixfmontnsethereafter
data need not be disclosed to y
unless a dispute or action is pending or additional data �on
you has been coll.ected. zC�ual cos�.s in making,
B . vou may be required to P�Y `re copies os information
certifying ar.d/or compiling
reguested. �
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Date of Re�nest:
Keq�ester Name: � ��` ��. � � .1
Ad
dress: � ��'� City: l-� `�`Z
zip: -���i I/ _ ^ ,� .
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g�e Phone: � �
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Description of Informat�on R�?uested: �
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Re�aester' s Signature:
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BELOW INFORMATION: TO BE FII,LE� IN BY DEP_z1RT'�'NT ONZY
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Depart�e.nt=
Reqaest Type= _Tn Pe='sen
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equested By: Subjec� of Data
Not Sub j ec� of Data
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=nfoZmation Requested is Classified:
Nor�-�uD1=-c =rotected Von-Public
Conf idential —
Denie� A�proved in Par�
ge�uest is= Approve� — "
Remar�cs/Camments-
Authorize3 Signature:
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Fe�s: p es Rate per Page �-
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New Thou ht Church
. 9'
� of Religious Scienee
To: City of Orono
Date: November 14, 2005
Re: Property information
I hereby authorize Mark and Elizabeth Odegard, acting as realtor agents for the New
Thought Church,to obtain any records, plans, blueprints, etc that are on file with the city
for our church property: 525 Leaf St., Long Lake,MN.
Thank you, �
��� � �
� ����
Rev. Glenn Chaffin �
525 Leaf St. Long Lake, MN 55356 952-473-0350 www.newthoughtcrs.org
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'-��� Re uest for Re rint of Oversized Documents
� � �.: �, 9 P �
�'� �� �� or Building Plans and Blueprints
��kEsHo�'�
Date of Request: �� � � � � `=-'�' S�
Document Address: � � S L �z_� ST
Name: _ �� �'�`� C���� ?-l���
Address: �'7�-' (:�> �. � '� �= �7
City: r���'L� r� ��-,-� � �- L��o �`� State: �'� r� Zip: � ���:: ��-7
Phone: �" � � �� 3 � � `-1 � �- -----
(Work) (Home)
Description of document(s) to be reprinted: j ��;�h G �' �� ;�y-���;.�
' 1 /� � / ��� �.'J�c�� L K: �� � 1 �
CHARGES: All char es must be paid at the time of the reQuest, and are non-refundable.
Requests must be picked up at the City offices unless other arrangements have been made. The
charges for reprints of oversized documents and building plans/blueprints are based on the
following:
Cost of Prints: 7���y � c�;; � C-�. C�o
Special Handling Fee: I� . S O
Pickup/Delivery Fee _______$12.00 ____
Subtotal �ca, ,5 D
6.5% Tax (prints/handling/delivery): 3 • Sy
Clerical Fee $ 5.00
TOTAL � .���y
��Ci�.�- 1 �--� �
(signature
2750 Kelley Parkway,P.O.Box 66,Crystai Bay,MN 55323
Phone: 952-249-4600/Fax: 952-249-4616/www.ci.orono.mn.us
ti. „
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January 19, 2005
Calculatin� Char�es for Reprints:
1. Image
Each image scan= $5.00
2. Print on Bond Pa er
Paper Size Cost to Scan Cost for First Total Cost for Cost for Each
Print One Print Additional Print
11 x 17 $5.00 $1.00 $6.00 $ .40
17 x 22 $5.00 $1.50 �6.50 $ .60
22 x 34 $5.00 $3.00 $8.00 $1.20
34 x 44 $5.00 $5.50 $10.50 $2.20
Add the image scan cost of$5.00 plus the cost of the print by paper size; i.e. a 17 x 22"reprint would cost
$6.50
The size of the reprint depends on what size the customer wants and the size of the original drawing.
Sometimes the customer wants the reprint to be the same size as the onginal,but it could also be smaller
or larger.
3. Special Handling Fee
1-3 images No Charge
4-9 images $12.50 (approximately '/4 hour)
10+images $�(approximately '/z hour)*
*If you have approximately 20 images, it would be $50.00.
4. Pickup/Delivery Fee
$12.00—includes both pickup and delivery
5. Sales Tax
Add 6.5% sales tax on Prints, Special Handling fee and Pickup/Deliver Fee.
6. Clerical Fee
$5.00 as listed in the Orono Fee Schedule
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;�d! Rec�i.�ad ;�3.c>- ;,i
V:\(Forms)�Request for Reprint of Oversized Documents.doc ':.l,��[ �,;'�;i
:kf�� !:►� T�i�f�i� '7(M:�f,
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Instructions for Reprint of Microfilm
1. One (1)reprint of each microfilm image on enclosed film—total5 images
2. Reprint each on bond paper to 11"x 17"size
3. Return to City of Orono by Tuesday November 22, 2005.
4. Any questions,please call Denise at 952-249-4604.
t �,
PAGE 1 CUSTOMER COPY INVOICE DATE 11/18/2005
ENGINEERING REPRO CUST ID 960280
SYSTEMS
3005 Ranchview Lane North
Plymouth, MN 55447 INVOICE NO 119173
USA
(763)-694-5900 ORDER NO P0058551
S 960280 S Denise
p ORONO,CITY OF H SB,
� P.O. BOX 66 �
p CRYSTAL BAY, MN 55323-0066 P
T T
O �
IVET DUE 58.02
- - ------
-- __ _ _
__.___ .__ ___ __.. _ _ _ __ __ _ __ _ _ _ _--
�LS1 SLS2 DUE DATE DISC DUE DATE ORDER DATE PLANWELL/EWO ID
__ -- --__- .._ __
___ ___- --____--- _ __ ___ ____.._ _ _-- _-- _ - _ _._ _. . _ _ __
00 12/1812005 11/18/2005 11/16/2005 ���S L��.� S-�
—______-- --.. --------- --
'ERMS DESCRIPTION CUSTOMER PO NUMBER SHIP VIA
____ ---- ----- -- - -------
i/30 5 Microfilm
---- ---—- ----- .._--— ------------ ---- --- -- -----_.--
TEM ID TX CL UNIT ORDERED SHIPPED UNIT PRICE EXTENSIOM
_._-._---.---.__
_ - -_ _-- -
------ --. _...-- ------- -
�LY CS 3 EA 5.0000 5.0000 5.0000 25.00
;ARD SCAN
� set(s)of 5 Card Scan
'LY HANDLING I 0 HR 2500 2500 40.0000 10.0�
1ANDLING IMAGING
I set(s)of 1 Handling
�LY BOND File F 0 SQ/FT 10.0000 10.0000 .6000 6.00
=1RST SET ELEC BOND PLOTS
I set(s)of 5 11.00x17.00 Bond
=lectronic Original
':;{���
� '�
`i, 6 U
✓V
... .. . __-__...
.. ....._....... .._.____.... _.... _. .
TAXABLE NONTAXABLE FREIGHT SALES TA� MISC TOTAL
_._ _ _ _ ___ _ _ ...___. _
16.00 25.00 15.00 2.02 0.00 58.02
_ _ __
PRIOR INVOICES 0.00 PRE'�AYME�lT 0.00 NET DUE 58 02
> ,� �..�ra.
� ,
Order`ID: Fl0058551 � � . Q�� F Engineering
Account #: sso2so � Re ro
P
PO #: 5 Microfilm Hlo�wi�' ID: Systems
JOB #: PlanWell ID:
Delivery Type: ERS Delivery �
Due Date: 11/18/2005
Due Time: 12:00 PM
Ship To:
Company Name: ORONO, CITY OF
Attn: Denise
Address: 2750 Kelly Parkway
Long Lake, MN 55356
Company Shipping Notes:
Return jobs to Repro DB Shipping Address. The main address is their mailing address.
Description Item ID Unit Shipped
1 set(s) of 5 Card Scan PLY CS EA 5
1 set(s) of 1 Handling PLY HANDLING I HR 1
1 set(s) of 5 11.00x17.00 Bond Electronic Original PLY BOND File F SQ 10
Total Freight Freight $$ 15
� 2o c� o � `��.�� � ,� � s
� � v1v � �p� c�
Received By:
Printed on: 11/16/2005 2:43:47 PM Page 1 of 1