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� <br /> � � <br /> ' � �01�T� Request for Reprints of Oversized <br /> Documents, Building Plans and Blueprints <br /> y � <br /> F L1 <br /> I9'�ESHO4�, <br /> Date of Request: - i ,� <br /> Docum Address: �) � 1 �v � � ► � � �J � <br /> Name: �� E? � 1� <br /> Address: �-�-�� �(,�.1(� � <br /> � <br /> City: �Y101�. � State: �� Zip: ���� <br /> Phone: � " ��� " ��� � <br /> (Work) (Home o <br /> Description of document(s) to be reprinted: t.� f' <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. <br /> The charges for reprints of oversized documents and building plans/blueprints are based on <br /> the following: <br /> Cost of lst Prints �@ $ ( C`� ea. _ � . 3� <br /> Additional Prints @ $ ea. _ <br /> Cost to Scan �@ $ 5.00 ea. _ ==>,�Z_ v O <br /> Pickup/Delivery Fee 17.50 <br /> Set-up Charge 20.00 <br /> Energy Charge 2.39 <br /> Subtotal x� - ��4 <br /> 7% Tax � -I�; <br /> Clerical Fee 5.00 <br /> TOTAL =_____� '�_�'� <br /> �-�"—��--\-�,� <br /> � e --_. <br /> ( ' ature) <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 />